Weber R, Draf W, Keerl R, Schick B, Saha A
Department of ENT Diseases, Head, Neck and Facial Plastic Surgery, Communication Disorders, Hospital Fulda, Academic Teaching Hospital of the University of Marburg, Germany.
Am J Otolaryngol. 1997 Jul-Aug;18(4):247-53. doi: 10.1016/s0196-0709(97)90004-1.
We evaluated the long-term results and complications of endonasal pansinusoperation in chronic polypoid sinusitis.
In a retrospective study, 170 patients were followed-up for 20 months to 10 years after bilateral endonasal microendoscopic pansinus surgery or ethmoidectomy. The follow-up consisted of a standardized questionnaire and clinical examination with the flexible endoscope.
We found that 85.6% of the ethmoid cell systems, 69.4% of maxillary sinuses, and 37.5% of frontal sinuses could be visualized endoscopically. The ethmoid mucosa was normal in 56% and thickened in 19%. Recurrent polyps were found in 25%. The evaluation--as per the graduation of results defined by us as a combination of examination findings and subjective assessment of the operative result--resulted in an operative success of 92%. Two studies dealing with the frequency of complications showed injury to the dura in 2.3% to 2.55% and periorbital injury without permanent sequelae in 1.4% to 3.4%. Because of two cases of bleeding from the internal carotid artery, the problems of vascular complications in particular will be thoroughly discussed.
More than 90% of patients with chronic polypoid sinusitis gain long-term satisfying results after endonasal ethmoidectomy with microscope and endoscope. For minimizing the risk of injury of the optic nerve or the internal carotid artery preoperative, computed tomography is necessary. A special training program is recommended.
我们评估了慢性息肉样鼻窦炎鼻内镜全鼻窦手术的长期疗效及并发症。
在一项回顾性研究中，对170例患者在双侧鼻内镜下微内镜全鼻窦手术或筛窦切除术后进行了20个月至10年的随访。随访包括一份标准化问卷以及使用可弯曲内镜进行的临床检查。
我们发现，85.6%的筛窦气房系统、69.4%的上颌窦以及37.5%的额窦可通过内镜观察到。筛窦黏膜56%正常，19%增厚。发现25%有复发性息肉。根据我们定义的结果分级，结合检查结果和手术效果的主观评估，手术成功率为92%。两项关于并发症发生率的研究显示，硬脑膜损伤发生率为2.3%至2.55%，眶周损伤且无永久性后遗症的发生率为1.4%至3.4%。由于发生了两例颈内动脉出血，将特别深入讨论血管并发症问题。
超过90%的慢性息肉样鼻窦炎患者在接受显微镜和内镜下鼻内镜筛窦切除术后能获得长期满意的效果。为将术前视神经或颈内动脉损伤风险降至最低，有必要进行计算机断层扫描。建议开展专门的培训项目。
