内窥镜鼻窦手术中上颌窦自然开口的处理

目的 探讨内窥镜鼻窦手术中寻找和处理上颌窦自然开口的方法和意义。方法 利用不同途径寻找到上颌窦开口后,根据窦口的形态和上颌窦本身的病变情况,决定扩大或不扩大开口,在不引起并发症的前提下,使扩大的窦口直径＞1cm。结果 515例慢性鼻窦炎、鼻息肉患者经术后6个月的随访,窦口开放率为86.2%（444／515例）,闭锁率为13.8%(71/515例）。结论 上颌窦口的开放与否是内窥镜鼻窦手术疗效评定的重要依据,术中正确处理窦口及术后定期随访是保证窦口长期开放的关键。

Management of ostium of maxillary sinus in endoscopic sinus surgery

Objective To investigate the clinical significance and methods of management of maxillary sinus ostium in endoscopic sinus surgery (ESS). Methods After finding the ostium by different ways, whether enlarging the ostium or not will depend on the shape of the ostium and the maxillary sinus disease. In premise of absence of complications, the diameter of ostium can be enlarged 1 cm at least. Results 515 cases of chronic sinusitis and nasal polyp should be followed up for 6 months after ESS. The patency rate of maxillary ostia was 86.2% and the closure rate was 13.8%. Conclusion The patency of maxillary ostia is an important basis for evaluating the effectiveness of ESS. Accurate management of the ostium during the operation and regular follow up after the operation are the key points to assure the long-term patency of the ostia.