Patency of the maxillary sinus ostium in healthy individuals

In a group of 20 healthy subjects the patency of the maxillary ostium has been evaluated in 35 maxillary sinuses with three different techniques: simultaneous pressure recording in the sinus and the ipsi- and contralateral nasal cavity; simultaneous recording of differential pressure between the sinus and the ipsilateral nasal cavity and air-flow through the ostium during nasal breathing; recording of the pressure rise in the sinus with an artificial air-flow of 1 litre per minute applied to the sinus. The tests were carried out in sitting and recumbent positions. In 5 persons (10 sinuses) a retest was performed after 2 months. These subjects were also tested with an inflatable neck cuff in order to obtain an increased venous pressure. Rhinomanometry at rest and after physical effort was also performed. The pressure relationship between the maxillary sinus and the ipsilateral nasal cavity was 1:1 in both the sitting and the recumbent position, but less than 1 when the contralateral nasal cavity was measured. Pressure recording alone gives no quantitative information about the patency of the ostium. Determination of the ostial resistance during nasal breathing could be performed in 13 sinuses, but in the remaining 22 the ostia were too wide to give a measurable resistance. The equivalent ostial diameter during inspiration could be estimated in 12 of the sinuses from a diagram constructed from known ostial diameters in model experiments. With an artificial air-flow applied into the sinus, the equivalent ostial diameters could be estimated from the diagram in all cases. No statistical difference was found in comparable cases between the mean equivalent ostial diameters estimated with the two methods. The equivalent ostial diameters showed a statistically significant reduction in the recumbent position and after application of the neck cuff. A statistically significant relationship was also found between the airway resistance of the nasal cavity and the equivalent diameter of the ostium in sitting and recumbent positions. Such a relationship could not be found between the equivalent ostial diameters measured at rest and the nasal resistance recorded after physical effort.     

Pressure measurements in the normal and occluded rabbit maxillary sinus

Occlusion of the maxillary ostium is considered to be a key factor in the pathogenesis of maxillary sinusitis. In this study, the authors determined the effect of ostial occlusion on pressure in the rabbit maxillary sinus which, like most humans, has only one ostium. We compared pressures in the normal and occluded maxillary sinus and the nasal cavity during spontaneous breathing in anesthetized adult animals. Serial pressure measurements were obtained from sinuses with patent ostia in nasal-breathing rabbits and with occluded ostia in both nasal-breathing and tracheotomized animals. Sinuses with patent ostia showed pressure curves synchronous with the respiratory cycle. Inspiratory and expiratory pressures in the nasal cavity and the sinus were isobaric. Sinuses with occluded ostia initially developed a positive pressure followed by a negative pressure that reached a subatmospheric plateau of-28.2 ± 7.3 mm H₂O (mean ± standard deviation [SD]) within 20 to 50 minutes. This is the first quantitative study of sinus pressures using the rabbit as an animal model. The findings may contribute to a better understanding of the role of ostial occlusion in the pathogenesis of maxillary sinusitis in humans.     

鼻内窥镜术上颌窦自然开口的处理

探讨内窥镜鼻窦手术治疗慢性鼻窦炎，鼻息肉的上颌窦中鼻道开口的重要性及处理方法。方法 配对研究５６例双侧鼻窦炎，鼻息肉患者，比较同一患者术中扩大或不扩大上颌窦自然开口的术后情况。结果 窦口的开放率在不扩大和扩大上颌窦自然开口的术侧中分分别为９２．９％和８０．４％。     

Role of the maxillary sinus as a resonant cavity]

Patients with a paranasal disorder often manifest voice change. Yet, computer simulation of these nasal sounds is difficult using a nasal tract model without any branching cavity. In other words, acoustic property of the nasal tract is influenced by a coupling with the paranasal sinuses. If the transfer function of the sinus acts as a Helmholtz resonator, the resonance frequency, or "zero" point, of the sinus would be present on the acoustic spectrum of the nasal cavity. This study was designed to prove the validity of this hypothesis. The sweep tone was given from the subjects' epipharyngeal space. The tone passed through their nasal space and radiated from the anterior nostrils. In 13 cases without nasal or paranasal disorders, the tones obtained at the nostrils were analyzed with Fast Fourier Transformation (FFT) and were compared between two conditions of the ostia of the maxillary sinuses, obstructed and opened with epinephrine. The resonance frequencies of the maxillary sinuses ranged from 1 to 2 kHz and varied considerably among individuals. This variation may be due to a difference in the maxillary sinus volume and in the diameter and length of the natural maxillary ostium. In past reports, in which the resonance frequency of the sinus was measured using a compound model or computed simulation, the maxillary sinus resonated below 1 kHz. In these reports the ostium of the maxillary sinus was regarded as a straight pipe. However, the examination of 29 cadavers revealed that the radius of the ostium differs according to its depth. The radius in the depth halfway from the edge was narrower than that of the edge. The way of evaluating a shape of the ostium is different between the present and the past studies, thus possibly resulted in discrepancy of the resonance frequency.     

Density of epithelial cells in the normal human nose and the paranasal sinus mucosa. A scanning electron microscopic study

214 biopsies of mucosa from various sites of the nose and paranasal sinuses were obtained post-mortem and examined using the scanning electron microscope. The density of ciliated cells was increased in the nasal cavity, in the antero-posterior direction. In paranasal sinuses the density of these cells was high, except near the ostium of the maxillary sinus, where the density was decreased by half. Non-ciliated epithelial cells were found in relatively few areas: anterior aspect of the middle and lower turbinates, anterior septum. However, no uniform distribution of these cells was present. The density of goblet cells was significantly lower in the paranasal sinuses as compared to the nasal cavity, with the highest density being found near the ostium of the maxillary sinus.     

鼻内窥镜术上颌窦自然开口的处理

目的探讨内窥镜鼻窦手术治疗慢性鼻窦炎、鼻息肉的上颌窦中鼻道开口的重要性及处理方法。方法配对研究５６例双侧鼻窦炎、鼻息肉患者，比较同一患者术中扩大或不扩大上颌窦自然开口的术后情况。结果窦口的开放率在不扩大和扩大上颌窦自然开口的术侧中分别为９２．９％和８０．４％（随访６个月时）。回顾性观察５１例施ＣａｌｄｗｅｌＬｕｃ术的患者，下鼻道造口的术后开放率仅为４０．６％。分析３８张单侧鼻窦炎或鼻息肉的鼻窦ＣＴ片，测量对照侧与病变侧的上颌窦口膜样部的上下径和前后径，差异无显著性。病变侧上颌窦口周围的中鼻甲气化、增生及钩突偏曲、筛泡骨性增生等解剖结构异常的发生率明显高于对照侧（Ｐ＜０．０５）。结论鼻内窥镜下处理上颌窦自然开口的关键是窦口周围的解剖异常因素。     

鼻内镜下上颌窦口处理方法的探讨

目的：探讨内窥镜鼻窦手术中上颌窦自然开口处理方法与预后的关系。方法：对慢性鼻窦炎、鼻息肉患者682例采用不同途径寻找上颌窦开口并根据窦口的形态和上颌窦本身的病变情况,决定开口方式与处理方法。结果：随访6个月,发现窦口开发率为84.22%(574/682例),闭锁率为16.88%（106/682）。结论：上颌窦口的处理方法是鼻内窥镜手术重要步骤,也是影响疗效与预后的关键因素之一。     

Effects of long-term induced ostial obstruction in the rabbit maxillary sinus

One of the widely proposed theories for mucocele formation is sinus ostial obstruction. Accordingly, this study was undertaken to investigate the long-term effects of ostial obstruction in the rabbit maxillary sinus and its potential role in the pathogenesis of mucoceles. Maxillary sinus ostial obstruction was induced on one side in eight Pasteurella-free White New Zealand rabbits using Histoacryl. The rabbits were housed in a Pasteurella-free zone for 24 weeks. At re-exploration, only three of the eight maxillary sinuses where ostial obstruction was induced showed pressure recording consistent with ostial obstruction. Mucociliary clearance activity was assessed using India ink. Swabs for culture were taken from the infected maxillary sinuses. Mucosal specimens for histopathological examination were harvested from one of the maxillary sinuses with obstructed ostium as well as from another sinus with nonobstructed ostium. The three maxillary sinuses with obstructed ostia showed gross evidence of infection and deranged mucociliary clearance, but no mucocele formation. Based on the findings of this study it is concluded that long-term ostial obstruction indeed plays a role in the pathogenesis of chronic sinusitis, but it did not induce mucocele formation in the rabbit maxillary sinus.     

Topical steroid drops for the treatment of sinus ostia stenosis in the postoperative period

BACKGROUND: Chronic oral steroid use causes significant morbidity, including osteoporosis, immunosuppression, and adrenal insufficiency. Refractory chronic rhinosinusitis patients often take repeated oral steroid courses to treat polypoid disease or sinus ostia stenosis. This study evaluated topical steroid drop efficacy in treating recurrent sinus ostia stenosis in the postoperative period. METHODS: The 5-year single institution experience with topical steroid drop use after endoscopic sinus surgery (ESS) was evaluated by retrospective review. Patients were included if they began topical dexamethasone ophthalmic, prednisolone ophthalmic, or ciprofloxacin/ dexamethasone otic intranasally (used off-label) within 3 months after ESS. Outcomes (i.e., ostia patency, oral steroid use, revision surgery, and complications) were assessed for a 6-month period after steroid drop initiation. RESULTS: Thirty-six patients met inclusion criteria. Forty-four surgeries were performed during the study period; 67 sides were treated postoperatively with topical steroid drops. In 86.6% of cases, steroid drops were used to treat frontal ostium stenosis or frontal recess edema; 93.2% of surgeries were revision procedures. Sixty-four percent of sinuses were treated successfully with topical steroid drops, 14.9% remained stable, and 20.9% failed. Reasons for failure included persistent/worsening edema, scarring, or noncompliance. Ten patients (27.8%) required oral steroids and 4 patients (6%) underwent revision surgery during the study period. One case of adrenal suppression occurred. CONCLUSION: Topical steroid drops are beneficial in preventing sinus ostia stenosis in the postoperative period and may decrease the propensity toward repeated oral steroid therapy. This is particularly noteworthy in this challenging cohort, largely composed of revision frontal sinus surgery patients.     

Mucociliary activity and ultrastructural abnormalities of regenerated sinus mucosa in rabbits

The purpose of this study was to observe histologic findings in the regenerated maxillary sinus mucosa and restoration of ciliary activity by measuring the speed of mucociliary transport after complete surgical removal of the maxillary sinus mucosa. The maxillary sinuses of 32 rabbits were opened anteriorly and one side of the sinus mucosa of each animal was completely removed. In 16 animals, the natural ostia were widened, and, in another 16 animals, the natural ostia were left undisturbed. The contralateral, sham-operated sinus was used as a control for each animal. The animals of each group were reanesthetized and the maxillary sinuses were reopened at planned intervals. The speed of mucociliary transport toward the maxillary ostium, determined by India ink particle movement, was reduced to 6.4 mm/min, whereas it was 10.8 mm/min in the control side. Beating cilia were observed in 16% by dark-field microscopy, in contrast to 66% in the control sinus. Pseudostratified columnar epithelia without cilia were present in 12%, with the remaining consisting of pseudostratified ciliated columnar epithelia (88%). Light microscopic examination showed increase in submucosal fibrotic proliferation, decrease in submucosal glands, and infiltration of inflammatory cells. Under transmission electron microscopy, abnormal cilia such as compound cilia or edematous cilia were frequently found in the regenerated specimens. These observations suggest that mucociliary clearance of the regenerated sinus mucosa may be significantly diminished compared with that of the original mucosa.     

Does nasal nitric oxide come from the sinuses?

OBJECTIVE: The purpose of this study was to assess nitric oxide (NO) output by the nose and sinuses. METHOD: In one volunteer, the osteomeatal complex and sphenoethmoidal recess were occluded to isolate the nose from the sinuses. The antrum and frontal sinus were each punctured by two catheters and irrigated with air at constant flow. Nitric oxide output and its rate of accumulation in the absence of air flow were measured in each sinus and in the adjacent nasal cavity. RESULTS: Prior to ostial occlusion, NO output in the nose was 96 nL/min. It decreased by 12% after blockage of all of the ostia. In the isolated sinuses, it was 190 nL/min (antrum) and 68 nL/min (frontal). After 5 minutes stagnation; NO concentration [NO] rose in the occluded sinuses to 24,700 nL/L in the antrum and 22,300 nL/L in the frontal sinus. In the nose, it increased to 29,000 nL/L. When the period of stagnation was prolonged in the frontal sinus, the [NO] reached a plateau. NO output and accumulation were not altered in the nose or either sinus by opening their ostia. In the antrum and frontal sinus, lidocaine reduced NO output and the rate of NO accumulation, but not in the nose. CONCLUSIONS: In this volunteer, 88% of nasal NO was derived from the nose itself. Nitric oxide exchange between the frontal sinus, antrum, and nose was negligible. In the absence of air flow, [NO] rose to a plateau in the nose and frontal sinus. Lidocaine inhibited NO output in the sinuses but not the nose.     

Acoustic rhinometry in healthy humans: accuracy of area estimates and ability to quantify certain anatomic structures in the nasal cavity

OBJECTIVES: We evaluated the accuracy of acoustic rhinometry (AR) measurements in healthy humans and assessed the ability of AR in quantifying the dimensions of the paranasal sinuses and certain anatomic structures in the nasal cavity. METHODS: Twenty nasal passages of 10 healthy adults were examined by AR and computed tomography (CT) before and after decongestion. Actual cross-sectional areas of the nasal cavity and actual locations of the nasal valve, the head of the inferior turbinate, the head of the middle turbinate, the ostia of the frontal and maxillary sinuses, and the choana were determined from CT sections perpendicular to the curved acoustic axis of the nasal passage. RESULTS: The AR-measured cross-sectional areas in the anterior nasal cavity were in reasonable agreement with the corresponding areas determined from CT, whereas AR consistently overestimated the passage areas at locations posterior to the paranasal sinus ostia. The nasal valve was identified as a pronounced minimum on the AR area-distance curve. However, AR did not discretely identify the head of the inferior turbinate, the head of the middle turbinate, or the choana. CONCLUSIONS: The local minima on the AR area-distance curve beyond the nasal valve are caused by acoustic resonances in the nasal cavity, and do not correspond to any anatomic structure. The AR area overestimation beyond the paranasal sinus ostia is due to the interaction between the nasal cavity and the paranasal sinuses, rather than to sound loss into the sinuses. Acoustic rhinometry provides no quantitative information on ostium size or sinus volume in either non-decongested or decongested nasal cavities.     

A human study model for nitric oxide research in sinonasal disease

Sinus nitric oxide (NO) measurements present a novel and promising approach to help overcome difficulties and confounding variables associated with nasal NO measurements such as the nasal cycle, ostial patency, and individual contribution to total NO production of each sinus. Conflicting results reported on nasal NO measurements in various sinonasal diseases are presumed to originate from the variable diffusion of sinus NO into the nose where it is measured. This study presents a novel technique and research method for direct measurement of sinus NO. The authors' original technique of individual, non-destructive catheterization of the sinuses through their natural ostia is developed and refined to allow accurate measurements of NO produced in the sinuses. Our study indicates that reproducible catheterization of the sinuses through their natural ostia can be performed in the clinical research setting under local and topical anesthesia. The model can be used to test the effects of various conditions on nasal and sinus NO production in a variety of disease models and the variables affecting sinonasal gas exchange can be differentially studied. Volunteer healthy adult human subjects without nasal allergies are used. An endoscopic nasal exam with topical anesthesia followed by in vitro allergy testing is performed to determine eligibility. Sinus computerized tomography (CT) scans are used to delineate anatomic features and to calculate paranasal sinus volumes. Continuous flow sinus air sampling and NO measurement with a chemiluminescence analyzer is obtained through polyethylene tube catheters (PEC) placed endoscopically into an aerated major paranasal sinus. Catheters are introduced through natural ostia under local and topical anesthesia. Nasal and differential sinus NO measurements are performed.     

Nasal obstruction: an alternative to ostiomeatal complex dysfunction in sinus disease

OBJECTIVES: Ostial patency is thought to be essential to the function of the maxillary sinus. Ostiomeatal complex dysfunction has been implicated as a major factor in the pathogenesis of sinus disease. However, recent work in our laboratory has indicated that other factors may also contribute to this process. The objective of this study was to determine the effect of nasal obstruction in maxillary sinus gas composition, independent of its effect on ostial ventilation. STUDY DESIGN: Prospective controlled animal study. METHOD: Independent models of nasal obstruction and ostial occlusion in contralateral sinuses were established. Ipsilateral models of nasal obstruction and ostial occlusion were also created. Gas samples from each of the manipulated sinuses were analyzed on a gas chromatogram and compared. RESULTS: Results revealed a dramatic and highly significant increase in antral carbon dioxide (CO2) concentrations in the sinuses ipsilateral to either an occluded ostium or an obstructed nostril, compared with the controls. These effects on CO2 concentrations were additive when ipsilateral nasal obstruction and ostial occlusion were created. Furthermore, the effect of nasal obstruction in modulation of antral CO2 levels was found to be beyond its effect on hypoventilation of the sinus and to be independent of ostial functional status. CONCLUSIONS: We have established independent models of nasal obstruction and ostial occlusion in the same animal. Our findings suggest that ostiomeatal complex dysfunction might not be the sole underlying factor in the pathogenesis of sinus disease in all individuals. Integrity of nasal airflow seems to have a significant effect on the maintenance of the aerobic antral environment, essential to the maintenance of normal sinus function. Modulation of maxillary sinus gas composition by nasal airflow, independent of ostial patency, may be explained by the possible presence of flow-sensitive receptors in the upper respiratory tract mucosa. Work to identify such receptors is currently in progress.     

上颌窦自然开口开放方式对上颌窦纤毛传输途径的影响

目的 对比全面开放和保留上颌窦下缘两种上颌窦自然开口开放方式对手术后上颌窦纤毛传输途径的影响,探讨内镜鼻窦手术(endoscopic sinus surgery,ESS)中开放上颌窦自然开口的恰当位置.方法设立3个观察组,观察示踪剂从上颌窦内向鼻腔的传出途径的差别.①正常对照组30例;②实验A组30例:ESS手术中全面开放和扩大上颌窦自然开口;③实验B组30例:ESS手术中采用上颌窦自然开口前缘和(或)后缘扩大、完整保留下缘.两个实验组均为慢性鼻-鼻窦炎经鼻内镜手术后12个月以上、窦口开放良好的病例.结果 ①正常对照组上颌窦内示踪剂均从自然开口下缘引流出,并直接进入中鼻道,其中下缘后份是核心区域;②全面扩大上颌窦自然开口组(实验A组)30例中,从下缘引流者4例(13.3%),从后缘和(或)上缘弥散进入筛窦者17例(56.7%),示踪剂堆积于上颌窦内和(或)在窦内呈旋转性传输运动,但不能引流出上颌窦者9例(30.0%);③保留上领窦自然开口下缘组(实验B组),全部通过下缘直接进入中鼻道(30/30,100%),无改变引流途径的病例.结论 ①上颌窦自然开口下缘是上颌窦纤毛传输的主要途径;②保留下缘的上颌窦自然开口扩大术后,上颌窦纤毛传输途径与正常人无差别;③全面开放上颌窦自然开口后,上颌窦纤毛传输途径发生改变,只有少数从自然开口下缘直接进入中鼻道,多数从上缘和(或)后缘弥散进入筛窦,部分积滞于上颌窦内难以排出.     

Effect of endoscopic sinus surgery on antral mucociliary clearance

Endoscopic sinus surgery (ESS) is the most used surgical approach in the treatment of chronic and recurrent maxillary rhinosinusitis. However, it still remains unclear how well surgery restores the mucociliary function in damaged maxillary sinus mucosa. There is also controversy whether to enlargen the natural ostium or not. We examined the mucociliary clearance (MCC) of maxillary sinuses in 27 patients with chronic and recurrent rhinosinusitis. On one side only an uncinectomy was done, on the contralateral side a middle meatal antrostomy was additionally performed. The mucociliary clearance (MCC) was measured in both sides preoperatively and 9 months after the operation. Measurements of the mucociliary clearance in maxillary sinuses were done using an isotope method. Preoperative mean residual activity on the uncinectomy side was 87.2 % and postoperative mean residual activity 94.1 %. On the middle meatal antrostomy side mean preoperative residual activity was 92.3 % and postoperative mean residual activity 88.4 %. Residual activity was considered as good (< or = 50 %) on the uncinectomy side in 2 sinuses (7.4 %) preoperatively and in 1 sinus (3.7 %) postoperatively. On the middle meatal antrostomy side residual activity was considered good in 1 sinus (3.7 %) preoperatively and in 4 sinuses (14.8 %) postoperatively. Mucociliary function remained poor even 9 months postoperatively. Surgery did not significantly improve the mucociliary function of maxillary sinus mucosa in chronic or recurrent rhinosinusitis. There was no statistical difference between operative techniques. In this study it seemed however, that uncinectomy combined with the enlargening of the natural ostium may restore maxillary sinus mucociliary clearance (MCC) better than uncinectomy alone.     

Acoustic rhinometry and paranasal sinuses: a systematic study in models, anatomic specimens, and in vivo

OBJECTIVE/HYPOTHESIS: Acoustic rhinometry (AR) evaluates the cross-sectional areas (CSA) of the nasal cavity through acoustic reflections. The aim of this study was to test whether the paranasal sinuses are a cause for the measurement of increased CSA in the posterior cavum of the nose. STUDY DESIGN:: Experimental study to evaluate the influence of paranasal sinus volume on AR measurements in two anatomic nose models, an anatomic specimen, and seven individuals. METHODS: The paranasal sinus volume was systematically reduced by filling of the maxillary sinus with saline. The paranasal sinus ostia were enlarged in the models and the anatomic specimen by infundibulotomy and supraturbinal fenestration, with AR repeated thereafter. RESULTS: No modification of the posterior area-distance curve was found in the models, the specimen, and the individuals after changing the volume of the maxillary sinus with unmodified anatomy of the paranasal sinus ostia. The apparent CSA measured in the posterior cavum after infundibulotomy and supraturbinate fenestration in the models and the specimen increased with the volume of the paranasal sinuses. CONCLUSION: Regular anatomy provided, AR reveals reproducible measurements that correspond with the actual CSA up to the ostia of the paranasal sinuses. Untypical large openings to the paranasal sinuses (e.g., after paranasal sinus surgery) appear to contribute to the inaccuracy of AR by overlapping paranasal sinus CSA with the posterior part of the area distance curve.     

Reevaluation of maxillary sinus surgery: experimental study in rabbits

Functional endoscopic sinus surgery concentrates primarily on the removal of ostiomeatal complex disease. When required, maxillary sinus ostioplasty is performed. However, surgical widening of a sinus ostium is contrary to common precepts. A study therefore was performed to reevaluate the effects of antrostomies and of intrasinus mucosal removal. Widening of the natural ostium, a separate antrostomy at some distance from the ostium, or radical mucosal removal was performed on 30 rabbits. Fifteen sinuses were used as controls. After 6 to 8 weeks the status of the sinus mucosa and mucociliary clearance was studied. The study confirmed that mucociliary clearance continued toward the natural ostium following inferior antrostomy. Following widening of the natural ostium, mucociliary clearance through the ostium redeveloped in 11 of 18 sinuses but was typically imperfect. There were no cases of ostial closure; however, the incidence of infection was significantly higher in all three experimental groups than in the control group.     

鼻窦内窥镜手术处理病变中鼻甲的意义

目的：探讨功能性鼻窦内窥镜于术（ＦＥＳＳ）中处理病变中鼻甲的临床意义。方法：按照成人中鼻甲解剖学标准,在３２例鼻窦炎、鼻息肉患者ＦＥＳＳ中,对病变中鼻甲进行适当处理,并于术后对中鼻甲形态恢复、筛窦术腔及上凳窦窦中开放率进行随访观察。结果：术后６个月中鼻甲形态恢复正常２４例（７５％）,发生粘连８例（２５％）,其中术腔闭塞２例（６．３５％）;上颌窦窦口开放良好２５例（７８．１％）,狭窄６例（１８．８％     

鼻窦球囊导管扩张术联合纤维鼻咽喉镜治疗鼻窦囊肿

目的 评价鼻内镜鼻窦手术和鼻窦球囊导管扩张术联合纤维鼻咽喉镜治疗鼻窦囊肿的疗效。方法 分析14例(19个上颌窦,3个额窦)应用鼻窦球囊导管扩张术联合纤维鼻咽喉镜手术切除鼻窦囊肿(球囊组)和16例(23个上颌窦,8个额窦)采用常规鼻内镜鼻窦手术方式切除鼻窦囊肿(常规组)病例的临床资料。依视觉模拟量表(visual analogue scale, VAS)记录手术难度评分和手术时间。手术前后均行鼻内镜检查、冠状位鼻窦CT检查,采用Lund-Kennedy内镜和Lund-Mackay鼻窦CT评分系统评价预后。结果 球囊组手术难度高于常规组,手术时间也较长,两组间差异有统计学意义（P<0.001）。术后观察8、24周, 鼻内镜检查见窦口通畅,Lund-Kennedy内镜和Lund-Mackay鼻窦CT评分结果显示,所有病例术腔恢复良好,术后鼻窦CT影像示改善明显,但两组比较差异无统计学意义（P>0.05）。结论 球囊组与常规组行鼻窦囊肿手术可获得同-良好的疗效。球囊组的手术方式能够保留鼻腔鼻窦的正常结构,手术微创。由于纤维鼻咽喉镜手术器械的限制,手术难度较常规组高,手术时间较长。