Weber R, Draf W, Keerl R, Behm K, Schick B
Klinik für HNO-Krankheiten, Städtisches Klinikum Fulda.
HNO. 1996 Sep;44(9):503-9. doi: 10.1007/s001060050045.
Most conditions of the frontal sinus requiring surgery can now be managed successfully by endonasal procedures. To date there has been no clear position regarding indications and results of different types of endonasal frontal sinus drainage. In a retrospective study we evaluated long-term results of Draf's type II and III endonasal frontal sinus drainages using endoscopy and computed tomography. Twelve to 98 months following type II drainage, 58% of 83 frontal sinuses were ventilated and normal. A ventilated frontal sinus but with hyperplastic mucosa was seen in 12%. Scarred occlusion with total opacification on CT occurred in 14%. Furthermore, total opacification in 16% was due to recurrent polyposis. Patients were free of symptoms or had only minor problems in 79%. Twelve to 89 months following type III drainage, 59% of 81 frontal sinuses were ventilated and normal. A ventilated frontal sinus with hyperplastic mucosa was seen in 17%. Scarred occlusion with total opacification on CT was present in 7%. Furthermore, total opacification in 16% was due to recurrent polyposis. In all, 95% of the patients were free of symptoms or had only minor problems. Combining our results with those of other authors and utilizing the physiology of wound healing after sinus surgery, we developed a protocol of differential indications for endonasal frontal sinus drainage.
大多数需要手术治疗的额窦疾病现在都可以通过鼻内手术成功处理。迄今为止，对于不同类型鼻内额窦引流的适应症和效果尚无明确的定论。在一项回顾性研究中，我们使用内窥镜检查和计算机断层扫描评估了Draf II型和III型鼻内额窦引流的长期效果。在II型引流后的12至98个月，83个额窦中有58%通气且正常。12%的额窦通气但黏膜增生。CT显示瘢痕性闭塞伴完全混浊的占14%。此外，16%的完全混浊是由于复发性息肉病所致。79%的患者无症状或仅有轻微问题。在III型引流后的12至89个月，81个额窦中有59%通气且正常。17%的额窦通气但黏膜增生。CT显示瘢痕性闭塞伴完全混浊的占7%。此外，16%的完全混浊是由于复发性息肉病所致。总体而言，95%的患者无症状或仅有轻微问题。将我们的结果与其他作者的结果相结合，并利用鼻窦手术后伤口愈合的生理学，我们制定了鼻内额窦引流的差异化适应症方案。
