Weber R, Kahle G, Constantinidis J, Draf W, Keerl R
Klinik für HNO-Krankheiten, Kopf-, Hals- und Plastische Gesichtschirurgie, Kommunikationsstörungen, Klinikum Fulda.
Laryngorhinootologie. 1995 Jul;74(7):423-7. doi: 10.1055/s-2007-997773.
The purpose of obliterating the frontal sinus is to provide a permanent solution to the underlying problem. The material of choice for obliteration is freshly removed abdominal fat. Using magnetic resonance imaging, one can assess the vitality of fat tissue in an obliterated frontal sinus without surgery. Eight patients ranging in age from 22 to 65 years underwent osteoplastic frontal sinus surgery with fat obliteration. The freshly implanted abdominal fat was postoperatively investigated using magnetic resonance tomography. The magnetic resonance examinations were carried out on a supraconductive 0.5 T Magnet (Gyroscan T S II, Philips Medicine Systems, Eindhoven, Netherlands) with a square head spool. We produced T1-weighted spin echo images (TR: 450-550 ms, TE: 20-25 ms), T2-weighted fast spin echo images or in double echo technique in transverse orientation (Tubo SE or TR-2000-2500 ms, TE: 50, 90 ms) and STIR sequences for fat suppression (TJ: 140 ms, TR: 1400 ms, TE: 30 ms). Our goal was to determine the time-dependent distribution of vital fat or fibrous tissue, development of necrosis, cysts, recurrences, inflammatory complications, or re-epithelization of the frontal sinus. Six to 24 months postoperatively, we found vital fat tissue in only three of eight cases. In the other five cases fat necrosis was present. The frontal sinus was filled by granulation tissue or fibrous tissue (once). It is not yet possible to determine when the fat changes to connective tissue. This process varies between individual patients. All eight patients were free of symptoms.(ABSTRACT TRUNCATED AT 250 WORDS)
闭塞额窦的目的是为潜在问题提供永久性解决方案。闭塞所选用的材料是刚切除的腹部脂肪。使用磁共振成像,无需手术就能评估闭塞额窦内脂肪组织的活力。8例年龄在22至65岁之间的患者接受了脂肪闭塞的骨成形性额窦手术。术后使用磁共振断层扫描对新植入的腹部脂肪进行研究。磁共振检查在一台带有方形头部线圈的超导0.5T磁体(Gyroscan T S II,飞利浦医疗系统公司,荷兰埃因霍温)上进行。我们生成了T1加权自旋回波图像(TR:450 - 550毫秒,TE:20 - 25毫秒)、T2加权快速自旋回波图像或横向双回波技术图像(Tubo SE或TR - 2000 - 2500毫秒,TE:50、90毫秒)以及用于脂肪抑制的短TI反转恢复序列(TJ:140毫秒,TR:1400毫秒,TE:30毫秒)。我们的目标是确定存活脂肪或纤维组织随时间的分布、坏死、囊肿、复发、炎症并发症的发展情况,或额窦的再上皮化情况。术后6至24个月,我们发现8例中只有3例存在存活脂肪组织。在其他5例中存在脂肪坏死。额窦被肉芽组织或纤维组织填充(1例)。目前还无法确定脂肪何时转变为结缔组织。这个过程在个体患者之间有所不同。所有8例患者均无症状。(摘要截断于250字)