鼻窦骨瘤手术进路的选择

目的:探讨鼻窦骨瘤手术进路的选择,分析各种手术的方法和特点。方法:31例患者中鼻 侧切开术14例,其中经典鼻侧切开术3例,扩大鼻侧切开术6例,单纯眉弓切口手术5例;鼻内镜下手术8例;冠 状切口颅骨切开术8例;Caldwell Luc进路手术1例。肿瘤彻底切除26例,部分切除2例。结果:术中出现脑脊 液鼻漏2例,均修补成功;术后出现球后出血,导致右眼失明1例。31例患者中随访28例,失访3例,平均随访时 间3.7年。彻底切除肿瘤的26例均无复发;部分切除肿瘤的2例带瘤生存。结论:鼻窦骨瘤手术进路的选择主要 依据骨瘤的位置、大小及鼻窦局部解剖特点以及有无重要神经、血管的侵犯等,也要考虑器官结构的功能、美容及 术者的经验和技术。

Surgery of osteomas of the sinuses

Objective:To explore the different surgical choices for treating osteomas of the sinuses. To summarize the management and characteristics of each surgical operation.Method:A retrospective evaluation of thirty-one patients with osteomas of the sinuses from June 1993 to December 2001 was presented. Fourteen patients were operated through a lateral rhinotomy with radical operation in 13 cases. Eight patients were operated by nasal endoscopic management, osteomas were completely removed. Eight osteomas were removed with a coronal incision. One case underwent Caldwell-Luc' surgery. The clinical symptoms, location of osteomas, and surgical procedures were analyzed.Result:The complications of brain spinal fistula occurred in 2 cases, but they were treated in the same time of operations. One patient had a single blindness after the operation. Twenty-eight cases were followed-up for 1 to 9 years with an average of three point seven years. Twenty-six patients had no recurrence, two cases lived with the remains of osteomas.Conclusion:The choice of surgical operations on osteomas of the sinuses was mainly decided by the location and size of osteomas, and the anatomic characteristics of sinuses, in the meanwhile, the organ function, the cosmetology, and the doctor's experience were taken into account.