关注额窦,提高额窦内镜手术的疗效

额窦手术一直是鼻内镜手术的难点,主要问题是额隐窝和额窦口狭小、解剖变异大,手术操作困难,局部黏膜容易损伤。目前国内外鼻内镜下比较成熟的额窦手术主要手术方式分别为Draf法、Wormald法、Friedman法及Stammberger法及改良Lothrop法等,以及扩大鼻丘气房入路扩大额窦开口的手术方式。仔细阅读CT,分析额隐窝的病理特征和解剖变异,保护额隐窝的可逆性黏膜完整,对于复杂额窦尽量扩大额窦开口,术后规范用药等是获得良好手术疗效的重要保证。

Frontal sinus, the key stone in current endoscopic period, needs more focus surgery

The surgical treatment for the disease related to the frontal sinus is still difficult. A lot of factors could lead to induce the difficulty at this region. First of all, the anatomic structures around the frontal sinus are complicated, which might confuse the operator during the surgery. The space for operation is quite narrow and surrounded by some im- portant structures. As this region is risky and too narrow to manage the disease with the instrument under angle endoscopy, the mucosa is easier to be hurt than other regions. Currently the most popular approaches valued highly in the world-wide ear nose and throat field include： Draf approach, Wormald approach, Friedman approach, Stammberger pre- cedure, Modified Lothrop approach and modified agger nasi cell approach. Besides, to observe the CT scan results care- fully, to analyze the pathological and anatomic characters of frontal recess in detail, to protect the mucosa and open the ostium of the complicated frontal sinus as wide as possible are also the key points for a remarkable therapy result.