Kinsella J B, Calhoun K H, Bradfield J J, Hokanson J A, Bailey B J
Department of Otolaryngology, Head and Neck Surgery, University of Texas Medical Branch, Galveston, USA.
Laryngoscope. 1995 Oct;105(10):1029-32. doi: 10.1288/00005537-199510000-00003.
Endoscopic sinus surgery (ESS) is now taught in most otolaryngology residency programs in the United States. However, this is technically challenging surgery and concerns exist regarding patient safety early in the surgeon's learning curve. The authors reviewed 193 cases of ESS performed by residents, under faculty supervision at our program, between 1987 and 1992. Sixty-seven percent of patients underwent bilateral anterior ethmoidectomy, 40% had bilateral total ethmoidectomy, and 44% had bilateral middle turbinate reduction. The overall complication rate was 22% and included one major complication. Synechiae accounted for 50% of minor complications. There was no correlation between middle or inferior turbinate reduction and the formation of synechiae. Posterior ethmoidectomy was not associated with a significant increase in complications. We conclude that ESS can be safely performed by otolaryngology residents in carefully structured and supervised training programs.
在美国，大多数耳鼻咽喉科住院医师培训项目都教授鼻内镜鼻窦手术（ESS）。然而，这是一项技术上具有挑战性的手术，并且在外科医生学习曲线的早期，患者安全方面存在担忧。作者回顾了1987年至1992年间在我们项目中由住院医师在教员监督下进行的193例ESS病例。67%的患者接受了双侧前筛窦切除术，40%进行了双侧全筛窦切除术，44%进行了双侧中鼻甲切除术。总体并发症发生率为22%，包括1例严重并发症。粘连占轻微并发症的50%。中鼻甲或下鼻甲切除术与粘连形成之间没有相关性。后筛窦切除术与并发症的显著增加无关。我们得出结论，在精心构建和监督的培训项目中，耳鼻咽喉科住院医师可以安全地进行ESS。
