鼻内镜下经筛窦行眶内壁骨折整复术

目的 :探讨应用鼻内镜下经筛窦行眶内壁骨折整复术。方法 :鼻内镜下经前鼻孔进入开放筛窦 ,将嵌入筛房的眶脂肪及内直肌还纳回眶内 ,应用 1mm厚硅胶板修补充填孔洞。结果 :4 0例患者 ,平均术后随访 12个月 ,复视消失 ,眼球内陷矫正 ,无硅胶排异。结论 :鼻内镜下经筛窦行眶内壁骨折整复术 ,具有皮肤无瘢痕、手术损伤小、并发症少 ,且手术安全可靠等优点     

鼻内镜下治疗顽固性鼻出血64例临床分析

目的 :探讨鼻内镜下治疗顽固性鼻出血的临床效果。方法 :回顾性分析我科 1999年 1月～ 2 0 0 2年 2月在鼻内镜下进行治疗顽固性鼻出血 6 4例的临床效果。结果 :全部病例均经一次止血治疗获得成功 ,随访 3个月～ 3年疗效满意 ,未见复发者。结论 :鼻内镜用于治疗鼻出血具有视野清楚 ,检查出血部位准确 ,止血迅速 ,疗效确切。在治疗顽固性鼻出血中有推广应用价值。但要掌握好适应证和禁忌证     

经鼻内镜筛窦径路治疗眶骨爆折的疗效观察

目的：探讨筛窦径路经鼻内镜手术治疗眶骨爆折的临床疗效。方法：总结1998年10月-2001年10月收治眶壁骨折患者19全然 ，均在鼻内镜下，行眶骨骨折整复术，结果：经6-12个月随访眶骨骨折19你，术后复视消失，眼球凹陷改善。结论：经鼻内镜筛窦径路手术治疗眶骨爆折，入路简捷，操作方便，眶内侵袭少，无面部疤痕，疗效可靠。     

鼻内窥镜下经筛窦治疗爆裂性眶内壁骨折

目的：探讨鼻内窥镜下经筛窦治疗爆裂性眶内侧壁骨折的可行性。方法：在鼻内窥镜下采用经筛窦术式治疗16例爆裂性眶内侧壁骨折病人,对其疗效进行分析。结果：随访0．5～1．0年,16例病人14例治愈,2例好转。结论：鼻内窥镜下经筛窦径路治疗爆裂性眶内侧壁骨折方法可行,不须做颜面部切口,视野清晰,不增加眶内新的损伤,术后反应轻,恢复快。     

鼻内窥镜下经筛窦治疗爆裂性眶内壁骨折

目的：探讨鼻内窥镜下经筛窦治疗爆裂性眶内侧壁骨折的可行性。方法：在鼻内窥镜下采用经筛窦术式治疗１６例爆裂性眶内侧壁骨折病人,对其效进行分析。结果：随访０．５￣１．０年,１６例病人１４例治愈,２例好转。结论：鼻内窥镜下经筛窦径路治疗爆裂性眶内侧壁骨折方法可行,不须做颜面部切口,视野清晰,不增加眶内新的损伤,术后反应轻,恢复快。     

经鼻内镜颅底手术18例临床分析

目的:探讨经鼻内镜行颅底手术的可行性和临床意义。方法:回顾性分析了我科1997年～2002年在鼻内镜下完成的颅底区域手术18例的临床资料。结果:10例脑脊液鼻漏修补术均一次获得成功。8例接受视神经管减压术,术后5例视力改善。结论:经鼻内镜颅底手术简便,损伤小,安全有效,是一项值得在临床推广的操作技术,但必须掌握好这类手术的适应证。     

鼻内窥镜在腺样体切除术中的应用

应用鼻内窥镜结合鼻腔切割吸引器行腺样体切除术５３例,其中单纯腺样体肥大（Ａ）１３例,腺样体肥大十扁桃体肥大（Ａ＋Ｔ） １２例,腺样体肥大十分泌性中耳炎（Ａ＋Ｓ） １０例,腺样体肥大十扁桃体肥大十分泌性中耳炎（Ａ＋Ｔ＋Ｓ）１８例,手术不仅适用于儿童,也适用于成人。本文对鼻内窥镜下腺样体切除术的优缺点进行了讨论。     

经鼻内窥镜颅底手术的探讨

报道1992年到1997年经鼻内窥镜鼻内筛蝶窦进路完成颅底区域手术28例,包括:①脑脊液鼻漏修补术17例,均一次手术治愈;②垂体瘤部分切除术4例,均一次手术治愈;③侵入颅内的巨大筛蝶窦囊肿切除术2例,1例治愈,1例因颈内动脉破裂出血于术中死亡;④前颅底脑膜瘤切除术1例,术后4年未复发;⑤鼻咽顶颅咽管瘤切除术1例,术后3年未复发;⑥侵犯鞍区的蝶窦癌切除术2例,1例术后2年未复发,1例术后介入治疗误栓颈内动脉死亡;⑦前颅窝枪弹异物取除术1例。根据临床实践,提出经鼻内窥镜颅底区域手术的可行性、范围和适应证,各种手术的操作原则和规范技术以及重大并发症的预防和处理方式。     

鼻内镜辅助下行眶下壁骨折复位术

我科采用经上颌窦入路鼻内镜辅助下行上颌骨与眶下壁骨折复位的新方法,对近1年收治的8例上颌骨眶下壁骨折患者进行治疗,取得满意疗效,报告如下。     

鼻内镜手术的眶并发症

随着鼻内镜手术技术的普及和提高,鼻内镜手术设备的不断更新,鼻内镜鼻窦手术的开展越来越广泛和深入,极大地提高了鼻腔、鼻窦疾病的手术治疗效果,拓宽了经鼻手术的适应证,但是,由此而引起的并发症跟传统手术比较却没有减少。本文拟就由经鼻内镜鼻窦手术引起的眶并发症作一综述。     

鼻内镜在治疗鼻源性眶内脓肿中的应用

目的 :探讨鼻内镜治疗鼻源性眶内脓肿的疗效。方法 :对 4 6例鼻源性眶内脓肿行内镜下切开引流及病灶根治术。结果 :4 1例患者 (89.1% )达到治愈 ,2例由于球后视神经炎而视力差 ,另有 3例残留不同程度的眼球运动障碍。结论 :对于鼻源性眶内脓肿应在脓肿切开的同时治疗原发病灶 ,鼻内镜对此类手术有优势 ,但仍需注意并发症的发生     

鼻内窥镜技术在面中部骨折治疗中的应用

报告8例面中部骨折病人，其中鼻额筛复合骨折6例，击出性骨折（眶底暴折）2例。治疗中结合鼻内窥镜技术，获得了术前诊断明确，术中操作细致、准确，术后恢复迅速，8例均治愈出院，随访半年～1年疗效满意。     

儿童眶底骨折的特点及治疗

本文报道应用CT扫描诊断的20例儿童眼底骨折的特点与治疗经验。男性15例,女性5例,年龄4～14岁。其中撞击伤12例,车祸5例,摔伤3例。手术治疗17例,保守治疗3例。眼球陷没治愈率100％;复视治疗成功率95％,失败率5％。本文就儿童眼底骨折的特点、诊断和治疗、手术适应证及手术方法进行讨论,认为早期诊断、早期治疗及术后早期运动训练是此病获得治愈的关键。     

Study on the treatment of traumatic orbital apex syndrome by nasal endoscopic surgery

Orbital apex syndrome (OAS) is a complex disease caused by a variety of pathological factors, and trauma is one of the main factors/causes. Clinical data of 17 cases of traumatic OAS treated by nasal endoscopic surgery in our department from January 2002 to April 2009 were gathered and reviewed. Among them, the six patients presented with OAS after injury to the lateral wall of orbital apex. Seven other patients exhibited OAS after injury to the medial wall of orbital apex, two displayed OAS after zygomatic trauma, while OAS manifested in the other two patients with craniocerebral trauma 3?days after they had decompressive craniotomy??of them, one was blind in both eyes. In the 17 cases, 6 patients were without light sensation, 1 was blind in both eyes; the sight-chart index of eight patients was 0.1, that of three other patients was 0.1?C0.2. Fifteen patients displayed eyeball movement disturbance (disorder) and cornea sensory disturbance (disorder), two were with the eyeball abducent disturbance. After the nasal endoscopic surgeries for OAS performed on the 17, the sight of the most patients was restored in varying degrees. The sight of nine patients was between 0.2 and 0.3, that of two patients was between 0.1 and 0.2, that of the other two patients was 0.1, and that of four patients remained unchanged. The eyeball movement and the cornea esthesia in 15 patients recovered from the surgeries, one patient recovered with good eyeball adducent movement and the cornea esthesia but with eyeball abducent disturbance, the other patient did not make a recovery from the eyeball immobility, cornea anesthesia and ptosis. A follow-up lasting 2?months to 2?years suggested that the 16 patients had stable recovery from the surgeries. Satisfactory results could be achieved in the treatment of traumatic OAS by nasal endoscopic surgery. From objective assessment of the therapeutic effects of traumatic OAS, it can be concluded that if a patient is diagnosed with fractures of the optic canal and the superior and medial walls of orbital apex, nasal endoscopic decompression of superior and medial walls of orbital apex and optic canal via the approach to the sphenoid and ethmoid sinuses is the most ideal operative therapy.     

Evaluation of orbital cellulitis and results of treatment

Optimal management of patients with orbital cellulitis depends on how accurately the disease is classified and on the appropriateness with which antibiotics and surgery are used to treat the disease. Therapy must be adjusted on the basis of the extent of the disease. In order to determine the balance of treatment modalities which is most beneficial for certain disease presentations, we reviewed a series of 303 patients with orbital cellulitis. The anatomical and bacteriological etiology of the disease was determined in each case on the basis of the examination, visual acuity, results of sinus radiography, results of culture, ultrasonography, and computerized tomography. To avoid the 5% complication rate that occurred in this series, an evaluation and treatment protocol is recommended.     

Endoscopic surgery for the treatment of rhinosinusogenic orbital complications in children

To-day, the problem of rhinosinusogenic orbital complications in children remains as topical as it used to be in the past. More than 70% of children with these conditions fail to receive adequate pathogenetic therapy during the first days after the onset of the disease because of poor diagnostics which leads to the development of severe purulent complications in both the paranasal sinuses and the orbit necessitating the surgical treatment. The use of endoscopic endonasal surgery in children with these problems provides a number of advantages, such as safety, efficacy, and physiological treatment. They promote a significant reduction in the duration of the treatment, permit to avoid unnecessary radical interventions, and prevent the development of relapses of the disease.