鼻内镜咽囊手术疗效观察

目的：探讨鼻内镜咽囊手术的疗效,并观察术后创面的变化。方法:鼻内镜手术治疗咽囊炎12例、咽囊囊肿8例。术后第3天起用生理盐水冲洗鼻腔、鼻咽, 每周鼻内镜下观察创面的变化。结果:治愈12例, 有效6例,无效2例。术后创面白膜在2～3周内脱落。结论:鼻内镜手术治疗咽囊炎、咽囊囊肿疗效较好、创伤小。     

鼻内镜引导下咽囊炎冷冻治疗5例报告

1998年以来，我科门诊在鼻内镜引导下，对5例鼻咽囊炎患者进行液氮冷冻治疗，获得满意疗效。现报告如下。     

鼻内镜下微波治疗咽囊炎的临床应用

目的：探讨鼻内镜下微波治疗咽囊炎的疗效,并观察术后创面的变化。方法：鼻内镜下微波治疗咽囊炎11例、咽囊囊肿6例。术后第2天起用生理盐水冲洗鼻腔、鼻咽,每周鼻内镜下观察创面的变化,并记录白膜脱落的时间。结果：治愈14例,有效3例。术后创面白膜在2～3周内脱落。结论：鼻内镜检查有助于咽囊炎的诊断。鼻内镜下微波治疗咽囊炎,术后用生理盐水冲洗鼻腔、鼻咽,疗效较好、创伤小。     

鼻内镜下治疗慢性泪囊炎

目的：总结鼻内镜下手术治疗慢性泪囊炎和术中切开泪囊时瘘口处理的经验。方法：选择鼻泪管堵塞、慢性泪囊炎（包括术后复发）患者90例、105眼,均行鼻内镜下处理。造瘘口采用EC耳脑胶粘合固定成形72眼,术中置硬膜外导管10眼,用银夹吻合泪囊后瓣与鼻黏膜瓣13眼,造瘘口用碘仿纱条填塞扩张成型5眼,用一次性5?ml注射器乳头将前后瓣撑开成型5眼。同期行鼻中隔高位偏曲矫正7眼,钩突肥大切除10眼,中鼻甲前端息肉样变切除9眼,鼻息肉6眼。结果：完全无溢泪92眼,好转8眼,无效5眼,有效率95.24% 。结论：泪囊鼻腔造口术造瘘口的处理可根据术者的习惯及手术经验、设备条件及术中切开泪囊后泪囊鼻腔黏膜瓣具体情况而定。     

鼻内窥镜下微波治疗咽囊炎6例报告

我科自 1 998年 5月～ 1 999年 1 2月对 6例咽囊炎施行鼻内窥镜下微波治疗 ,取得了满意的效果 ,报告如下。1　临床资料6例患者中男 4例 ,女 2例 ,年龄 1 8～ 39岁 ,病程 1～ 3年。 6例均以鼻后溢液 (有粘液或粘脓性分泌物自鼻咽流向咽部 )为主诉就诊 ,其中 4例主观感觉平日呼吸有臭味 ,晨起常有痂皮自鼻咽咯出 ,3例伴有鼻后异物感 ,1例感枕后部钝痛。鼻内窥镜检查 ,鼻粘膜色泽、鼻甲大小基本正常 ,鼻咽顶后壁中央部可见灰白色圆形隆起、表面光滑之囊肿样组织 ,大小约 0 .4cm× 0 .4cm～ 0 .8cm× 0 .8cm,其中 5例压迫囊肿上方有黄色粘液自囊…     

鼻内镜下电动切割吸引治疗咽囊炎15例

我院自2003年1月-2005年5月在鼻内镜下对15例慢性咽囊炎患者行电动切割吸引治疗，疗效满意，现报告如下。     

鼻内镜鼻腔泪囊造口术治疗复发性泪囊炎

目的探讨鼻腔泪囊造口术后复发患者,再次手术中的常见问题及其防治措施。方法2003年7月至2008年7月我科共收治鼻腔泪囊造口术后复发患者44例（44眼）,探讨再次手术中常见问题及防治措施,所有患者术后随访6个月至1年以上,观察疗效。结果术中常见的问题依次为出血、泪囊定位、骨孔大小及位置、造口的大小以及鼻及鼻窦疾病等。术后44例患者,有41例溢泪等症状完全消失,手术成功率达93.18%。结论专业的设备、熟练的手术操作、熟悉泪囊的解剖和适当的处理,有助于我们正确处理术中常见的各种问题,提高手术的成功率。     

鼻内镜下经鼻高位泪囊鼻腔吻合术治疗慢性泪囊炎的临床观察

目的　探讨鼻内镜下经鼻高位泪囊鼻腔吻合术（dacryocystorhinostomy,DCR）治疗慢性泪囊炎的临床疗效。方法　回顾性分析河北省沧州中西医结合医院2009年1月～2019年1月收治的141例（141眼）慢性泪囊炎患者,所有患者均采用鼻内镜下DCR治疗,2009年1月～2016年2月74例患者行鼻内镜下经鼻平中鼻甲腋DCR（低位DCR组）,2016年3月～2019年1月67例患者行鼻内镜下经鼻高位泪囊鼻腔吻合术（高位DCR组）,分析两组患者术后半年疗效。结果  低位DCR组患者治愈55例,好转10例,无效9例,治疗总有效率为87.8%;高位DCR组患者治愈59例,好转6例,无效2例,治疗总有效率97%,差异有统计学意义（χ2=4.12,P <0.05）。结论　鼻内镜下经鼻高位DCR治疗慢性泪囊炎疗效显著,安全有效,值得推广。     

经鼻内镜泪囊鼻腔造孔术治疗复发性泪囊炎

临床上鼻内径路和鼻外径路泪囊鼻腔造孔术后常因造孔狭窄或闭锁,导致手术失败,引起症状复发.再手术时要不要放置扩张管和如何放置一直有争议,我们在开展经典鼻内镜下泪囊鼻腔造孔术的基础上对手术方法进行改良,将硅胶扩张管逆行置入泪囊,以硬膜外麻醉导管"环扎"法固定于泪道,行手术28例,取得了满意的效果,现报告如下.     

鼻内窥镜下微波治疗慢性咽囊炎

我科于 1 998年 2月～ 1 999年 1 2月 ,在鼻内窥镜下对 8例慢性咽囊炎患者施行微波治疗 ,取得良好效果。现报告如下。1　资料与方法1 .1　临床资料本组 8例 ,男 5例 ,女 3例 ;年龄 1 8～ 56岁。病程 6个月～ 3年。8例均有鼻后溢脓症状。其中 4例有异物感 ,2例有耳鸣及耳闭塞感 ,2例有鼻塞。检查 :全部病例均在鼻内窥镜下见咽囊处粘膜增生肥厚 ,慢性充血 ,4例表面附有脓性分泌物 ,2例可见残余腺样体。全部病例均取病检 ,并见 3例咽囊内有粘液性白色分泌物 ,4例有脓液 ,1例组织增生。病检报告均为慢性炎症。1 .2　治疗方法患者取平卧头后仰位…     

Endoscopic management of lateral pharyngeal pouch

A patient with dysphagia including symptoms of regurgitation of food and worsening pulmonary symptoms was found to have a lateral pharyngeal pouch. The diagnosis was made by barium swallow study and confirmed by endoscopy. The characteristic barium swallow findings include retention of barium in a sac or diverticulum. Endoscopy showed a pouch in the left lateral pharynx, adjacent to the vallecula. Surgical therapy consisting of endoscopic stapling of the mucosal band separating the pouch from the pharynx was performed successfully, and the patient improved dramatically.     

鼻内镜下射频结合电动切削器治疗儿童腺样体肥大68例

目的：探讨鼻内镜下射频结合电动切削器治疗儿童腺样体肥大的疗效。方法：鼻内镜下为68例腺样体肥大患儿先行射频消融,再用电动切削器切除腺样体。结果：治愈63例,有效5例。结论：鼻内镜下射频结合电动切削器手术直观、微创、安全、有效。     

Endoscopic findings at the pharyngeal orifice of the eustachian tube in otitis media with effusion

Transnasal endoscopy of the pharyngeal orifice of the eustachian tube was performed on 155 ears with otitis media with effusion (77 ears of children, 78 ears of adults). In children, blockage of the orifice by mucopurulent nasal discharge was the most frequent finding (72.7%), followed by compression of the orifice by the adenoid tissue (52.0%), hypertrophy of the peritubal tonsil (16.9%), and edema around the orifice, especially at its posterior lip (10.4%). In adults, the most frequent abnormal finding was edema of the orifice (26.9%), followed by blockage of the orifice by mucopurulent nasal discharge (23.1 %), and atrophy of the orifice (10.3%). In 39.7% of cases findings were normal. Thus, main pathological findings associated with tubal dysfunction involved inflammation in the nasopharynx.     

Endoscopic stapling diverticulotomy for pharyngeal pouch

Fifteen endoscopic stapling diverticulotomy procedures were performed on 14 patients. Our preliminary results show the technique to be fast, effective and safe. Most patients resumed oral intake within 6 h post-operatively and were discharged from hospital within 24 h. The technique has many advantages over both the external diverticulectomy and the traditional Dohlman's procedure. The short operating time and short hospital stay are an advantage. Our follow-up period was between 1 and 12 months. Long-term results require evaluation.     

Endoscopic laryngo-pharyngeal surgery for elderly patients

Objective

Due to the rising number of elderly patients and advances in endoscopic devices, early laryngeal and pharyngeal cancers are increasingly found in elderly patients. In these cases, minimally invasive endoscopic larygo-pharyngeal surgery (ELPS) may be indicated. However, the safety and efficacy of ELPS in elderly populations has not been established. The purpose of this study was to investigate the safety, outcomes and feasibility of ELPS in very elderly patients.

Three-dimensional assessment of pharyngeal airway in nasal- and mouth-breathing children

Objectives

The aim of this study was to assess the pharyngeal airway space (PAS) in nasal and mouth-breathing children using cone beam computed tomography (CBCT).

Methods

Volume, area, minimum axial area and linear measurements (PAS-NL, PAS-UP, PAS-OccL, PAS-UT, PAS-Bgo, PAS-ML, PAS-TP) of the pharyngeal airway of 50 children (mean age 9.16 years) were obtained from the CBCT images. The means and standard deviations were compared according to sexes (28 male and 22 female) and breathers patterns (25 nasal breathers and 25 mouth breathers).

Results

There were no statistically significant differences (p > 0.05) between all variables when compared by sexes. Comparisons between nasal and mouth breathers showed significant differences only in two linear measurements: PAS-OccL (p < 0.001) and PAS-UP (P < 0.05). Airway volume (p < 0.001), area (p < 0.001) and minimum axial area (p < 0.01) had significant differences between the groups.

Conclusions

The CBCT evaluation showed that pharyngeal airway dimensions were significantly greater in nasal-breathers than in mouth-breathers.     

鼻内镜手术治疗额窦内翻性乳头状瘤

目的 探讨鼻内镜手术治疗侵及额窦的内翻性乳头状瘤（inverted papilloma,IP）的疗效.方法 回顾分析过去5年内所完成的127例鼻内镜手术治疗的IP病例,共有11例IP侵及额窦,其中有6例肿瘤基底部位于前筛内,采用Draf Ⅰ型手术治疗;5例IP的基底部位于额窦口及额窦内,3例采用Draf Ⅱ型手术,另外2例肿瘤广泛波及额隐窝、额窦,并且突破额窦间隔突入对侧额窦,采用Draf Ⅲ型手术（改良Lothrop术）.结果 术后随访1.5～5.5年,平均2.5年,有2例复发.结论 鼻内镜手术是一种安全有效的处理额窦内IP的方法,认真选择适应证,肿瘤基底部位的仔细处理和密切的术后随访对治疗成功至关重要.     

顽固性咽异感症病因学与伴随症状的相关性研究

目的研究咽异感症病因与伴随症状的关系,为临床初步诊断其病因提供依据。方法315例咽异感症患者仔细询问病史、系统检查,包括胃镜检查、胃食管24 h PH值测定、男性生物有效性睾酮(bioavailable tes-tostone,Bio-T)的检查、直立试验以及男子更年期综合征10个问题问卷调查,并对伴随症状、咽异感部位进行分析总结,明确病因后进行个体化治疗。结果315例患者中,茎突综合征11例、颈椎疾病7例、变态反应性咽炎5例、鼻后滴漏综合征(PNDs)21例、阻塞性睡眠呼吸暂停低通气综合症(OSHAS)7例、精神创伤29例、恐癌16例、抑郁焦虑83例、更年期综合征42例、自主神经功能紊乱11例、甲状腺疾病3例、胃食管反流27例、喉咽反流53例。其中133例部位恒定,182例部位游走不定;192例伴失眠多梦,62例伴月经紊乱,88例伴胸闷心慌,115例伴上消化道症状。结论咽异感症病因与伴随症状具有明显相关性,有时临床上可依据咽异感症的部位及伴随症状对病因进行初步诊断。