Vining E M, Yanagisawa K, Yanagisawa E
Department of Surgery, Yale University School of Medicine, New Haven, Conn.
Laryngoscope. 1993 May;103(5):512-9. doi: 10.1288/00005537-199305000-00006.
Functional endoscopic sinus surgery (FESS) has popularized the use of telescopes in sinus surgery and has emphasized the importance of nasal endoscopy and computed tomography (CT) in the evaluation of patients with diseases of the nose and paranasal sinuses. Variations in intranasal and sinus anatomy have been implicated in the etiology of chronic and recurrent sinusitis, and CT imaging has become an important diagnostic tool. Despite this, some patients present with symptoms and telescopic examination suggestive of sinonasal disease, yet demonstrate little abnormality on CT scan. The authors reviewed videoendoscopic and CT examinations of 100 consecutive patients with symptoms of sinus disease and found 9% of patients with abnormal telescopic examination in the context of negative CT findings. In those patients whose CT examinations were positive, telescopic nasal endoscopy was especially useful in delineating the type of soft tissue which obscured the area of the middle meatus. In those patients whose CT examinations were negative, telescopic examination demonstrated septal deflections, mucosal edema involving the middle meatus, as well as turbinate and adenoid hypertrophy. These findings demonstrate that telescopic nasal examination is an important diagnostic modality which often yields important information when evaluating patients with sinonasal disease.
功能性鼻内镜鼻窦手术（FESS）使鼻窦手术中望远镜的使用得到普及，并强调了鼻内镜检查和计算机断层扫描（CT）在评估鼻及鼻窦疾病患者中的重要性。鼻内和鼻窦解剖结构的变异与慢性和复发性鼻窦炎的病因有关，CT成像已成为一种重要的诊断工具。尽管如此，一些患者出现了提示鼻窦疾病的症状和望远镜检查结果，但CT扫描显示几乎没有异常。作者回顾了100例连续有鼻窦疾病症状患者的视频内镜和CT检查，发现9%的患者在CT检查结果为阴性的情况下，望远镜检查结果异常。在CT检查结果为阳性的患者中，鼻内镜检查在确定遮挡中鼻道区域的软组织类型方面特别有用。在CT检查结果为阴性的患者中，望远镜检查显示鼻中隔偏曲、中鼻道黏膜水肿以及鼻甲和腺样体肥大。这些发现表明，鼻内镜检查是一种重要的诊断方法，在评估鼻窦疾病患者时通常能提供重要信息。
