儿童慢性鼻窦炎的鼻内镜手术治疗

目的探讨鼻内镜手术治疗儿童慢性鼻窦炎的疗效及影响疗效的相关因素。方法回顾分析1999年1月~2003年4月经鼻内镜手术治疗儿童慢性鼻窦炎72例临床资料。结果随访12个月以上,根据内镜鼻窦手术疗效评定标准(1997·海口),本组72例中,治愈58例,治愈率80.6%,好转13例,好转率18.0%,无效1例,无效率1.4%,总有效率98.6%,未发生严重并发症。结论鼻内镜手术是治疗儿童慢性鼻窦炎的理想方法。但应注意选择手术时机,控制手术范围,加强术后管理。     

鼻内镜鼻窦手术120例分析

目的探讨鼻内镜鼻窦手术治疗慢性鼻窦炎鼻息肉的疗效及手术并发症.方法对1999年1月至2001年1月完成随访的120例鼻内镜鼻窦手术进行临床分析.120例中1型25例(20.8%),2型78例(65.0%),3型17例(14.2%).其中113例在局部麻醉及部分辅以静脉强化麻醉下完成手术.术后随访12～36个月,平均18个月.结果1型治愈率为80.0%,2型治愈率为74.4%,3型治愈率为58.8%.手术并发症的发生率为11.7%.结论鼻内镜鼻窦手术是治疗慢性鼻窦炎鼻息肉的有效方法.     

儿童及青少年鼻内镜手术

目的探讨儿童及青少年慢性鼻窦炎患者接受鼻内镜手术治疗的疗效及相关影响因素。方法对86例(132侧)儿童及青少年慢性鼻窦炎患者行功能性鼻内镜手术,术后随访换药6个月以上及药物综合治疗。结果86例患者治愈60例(69.8%),好转22例(25.6%),无效4例(4.6%),总有效率95.4%。结论儿童及青少年慢性鼻窦炎经保守治疗无效时行鼻内镜手术疗效满意,其手术技术和术后随访及综合治疗影响手术远期疗效。     

同期与分期手术治疗慢性鼻-鼻窦炎合并泪囊炎的临床疗效比较

目的 比较同期与分期手术治疗慢性鼻-鼻窦炎合并泪囊炎的临床疗效.方法 选取2015年10月～2019年6月于东北国际医院诊治的慢性鼻-鼻窦炎合并泪囊炎患者94例,按手术不同分为同期手术组(n=58)和分期手术组(n=36),同期手术组加以同期鼻内镜下鼻窦开放手术和泪囊鼻腔造孔术,分期手术组一期加以鼻内镜下鼻窦开放手术,...     

鼻内镜下鼻窦手术1135例疗效的回顾性分析

目的探讨鼻内镜下鼻窦手术治疗慢性鼻-鼻窦炎的远期疗效以及可能影响疗效的相关因素。方法回顾性分析1135例(2107侧)慢性鼻-鼻窦炎和(或)鼻息肉患者鼻内镜下行手术治疗的临床资料。结果所有患者术后随访1～3年,平均1.2年。治愈8 6 2例(7 5.9%),好转2 1 4例(18.9%),无效59例(5.2%),总有效率94.8%。术后并发鼻腔粘连126例(11.1%)。结论鼻内镜下手术治疗慢性鼻-鼻窦炎,术中采用控制性低血压,减少出血,提供清晰术野,正确处理病变的中鼻甲,术后规范性随访,能有效的提高慢性鼻-鼻窦炎患者的治愈率,减少远期并发症。     

青少年慢性鼻窦炎的鼻内镜手术疗效探讨

目的探讨鼻内镜手术对青少年慢性鼻窦炎的治疗效果。方法对收住入院的105例青少年慢性鼻窦炎病人实施鼻内镜鼻窦手术,同时纠正影响鼻窦炎的某些相关因素,如鼻中隔偏曲、泡状中鼻甲、钩突肥大、中鼻甲反向偏曲,腺样体肥大和(或)扁桃体炎等。结果本组105例中,随访6个月至2年,术后鼻塞、脓涕、头疼等症状消失者71例(67.6%),鼻部症状明显减轻或改善者25例(23.8%),无效者6例(5.7%),加重3例(2.9%),总有效率为91.4%。结论鼻内镜鼻窦手术治疗青少年慢性鼻窦炎是一种行之有效的方法。在治疗青少年慢性鼻窦炎的同时,也要同时处理影响手术疗效的其他相关因素。     

儿童慢性鼻-鼻窦炎不同治疗方式的疗效分析

目的:探讨不同治疗方法在儿童不同类型慢性鼻-鼻窦炎的临床效果.方法:选取88例5～14岁慢性鼻-鼻窦炎患儿并分为3组:慢性鼻-鼻窦炎不伴鼻息肉患儿(A组)30例60侧,予以系统药物治疗;慢性鼻-鼻窦炎不伴鼻息肉伴腺样体肥大(B组)31例62侧,予以鼻内镜下腺样体切除联合系统药物治疗;慢性鼻-鼻窦炎伴鼻息肉患儿(C组)27例54侧,予以功能性内镜鼻窦手术联合系统药物治疗.结果:全部患者随访12～18个月,平均14个月.A组60侧,治愈48侧(80.0%),好转8侧(13.3%),无效4侧(6.7%);B组62侧,治愈46侧(74.2%),好转10侧(16.1%),无效6侧(9.7%);C组54侧,治愈40侧(74.1%),好转8侧(14.8%),无效6侧(11.1%),3种方式的治愈率和有效率差异无统计学意义(P>0.05).结论:儿童慢性鼻-鼻窦炎应根据不同类型采取不同的治疗方式,首选系统药物治疗,伴腺样体肥大慢性鼻-鼻窦炎患儿可同期行经鼻内镜下腺样体切除,慢性鼻-鼻窦炎伴息肉患儿可行功能性内镜鼻窦手术.     

儿童鼻内镜鼻窦手术30例临床分析

目的 探讨儿童开展鼻内镜手术治疗鼻息肉、鼻窦炎的经验、体会。方法 对30例儿童慢性鼻窦炎、鼻息肉病人全麻下行鼻内镜手术，术后随访1年以上。结果 治愈12例(40％)，好转14例(46．7％)，无效4例(13．3％)，总有效率86．7％。术后并发症主要是鼻腔粘连、窦口狭窄和闭锁。结论 鼻内镜鼻窦手术治疗儿童鼻窦炎、鼻息肉具有良好的疗效，但术者应十分熟悉儿童鼻窦的解剖特点，手术以纠正鼻腔、鼻窦的解剖异常、恢复其良好的通气和引流为目的，术后加强随访复查和综合治疗以提高疗效。     

常规照明下利用鼻内镜器械行鼻窦手术的体会

目的：介绍常规照明下利用鼻内镜器械行鼻窦手术的经验。方法：分析227例慢性鼻窦炎、鼻息肉病人在额镜照明下利用鼻内镜器械手术的疗效。结果：随访半年以上，227例病人治愈、好转、无效率分别是53．7％(122／227)、30．4％(69/227)、15．9％(36/227)；并发症14例。结论：额镜照明下利用鼻内镜器械行鼻窦手术治疗慢性鼻窦炎、鼻息肉疗效满意，优于传统鼻窦手术，可在不具备内镜的基层医院开展。     

慢性鼻-鼻窦炎鼻内镜术后鼻腔粘连的预防及处理探讨

目的分析与探讨鼻内镜治疗鼻-鼻窦炎术后鼻腔粘连的预防及处理,以进一步提高鼻内镜鼻窦手术的疗效。方法总结我科2015年8月~2016年6月收治的80例慢性鼻窦炎患者施行鼻内镜手术后发生鼻腔粘连情况进行分析。结果 80例患者中,未发生黏连61例(占76.2%);发生黏连19例(占23.8%)。结论功能性鼻内镜手术是治疗慢性鼻-鼻窦炎最有效的临床方法之一,鼻腔粘连是影响鼻内镜手术疗效的重要原因,加强围手术期治疗和术后定期随访是防止鼻内镜术后发生鼻腔粘连,提高鼻内镜手术治愈率的关键。     

Adenoidectomy vs endoscopic sinus surgery for the treatment of pediatric sinusitis.

OBJECTIVE: To compare endoscopic sinus surgery with adenoidectomy for the treatment of refractory chronic sinusitis in children. STUDY DESIGN: Prospective nonrandomized study in a pediatric otolaryngology service of a university teaching hospital. PATIENTS AND METHODS: Sixty-six children consecutively referred to the pediatric otolaryngology service between 1994 and 1997 with computed tomographic documentation of sinusitis subsequently underwent endoscopic sinus surgery or adenoidectomy. Their ages ranged from 2 to 14 years. Sixty-one children received follow-up. Two main outcomes were documented: (1) symptom status at least 6 months after the intervention and (2) requirement of the alternate procedure or a revision procedure. RESULTS: Twenty-four (77%) of 31 children who underwent endoscopic sinus surgery had improved symptoms, compared with 14 (47%) of 30 children who underwent adenoidectomy (odds ratio [OR], 3.9; P = .01). Multivariable analysis demonstrated that endoscopic sinus surgery was significantly better than adenoidectomy after age, sex, allergy, asthma, day care attendance, and computed tomographic stage were adjusted for (OR, 5.2; P = .03). The diagnosis of asthma also appeared to be an independent predictor of success (OR, 4.37; P = .03). CONCLUSION: Endoscopic sinus surgery is better than adenoidectomy for the treatment of refractory chronic sinusitis in a select group of children.     

Endoscopic sinus surgery for the treatment of chronic sinusitis in geriatric patients

Although endoscopic sinus surgery is a well-documented procedure for the treatment of chronic sinusitis in children and adults, no study has been conducted to specifically investigate its application in a geriatric population. We undertook to fill this void by analyzing the records of 1,112 patients who had undergone endoscopic sinus surgery for chronic sinusitis in our department between April 1988 and March 1998. We categorized these patients by age. There were 171 patients (15.4%) in the geriatric group (age: > or = 65 yr), 837 patients (75.3%) in the adult group (age: 17 to 64), and 104 patients (9.4%) in the pediatric group (age: < or = 16 yr). We found that the geriatric group experienced a disproportionately larger share of operative complications, but most of them were minor. Outcomes were similar in all three groups. We conclude that endoscopic sinus surgery is a safe and effective treatment for older patients with chronic sinusitis.     

Timing of Endoscopic Sinus Surgery in Children: Is There an Impact on Outcome?

OBJECTIVES/HYPOTHESIS: Endoscopic sinus surgery in children continues to be a controversial issue. Major factors in determining when to operate are the duration of the disease and duration of medical treatment. STUDY DESIGN: Prospective study of children referred to a tertiary center. PATIENTS AND METHODS: Eighty-three patients underwent endoscopic sinus surgery for refractory chronic sinusitis. All patients were followed prospectively to evaluate their response to surgery for a mean follow-up period of at least 1 year. A chi2 analysis and logistic regression analysis were performed to determine statistical difference between duration of symptoms and outcome. RESULTS: The overall success rate of endoscopic sinus surgery was 80%. Children who had surgery between 6 and 12 months of symptoms despite continued medical therapy had an 84% success rate, those who had surgery between 12 and 18 months had a 74% success rate, and those with more than 18 months of treatment for symptoms had an 81% success rate (P > .05). CONCLUSIONS: Duration of the symptoms of chronic sinusitis in children of more than 6 months was not a predictor of success of endoscopic sinus surgery in these children. Although there seemed to be a trend toward having a more successful procedure in children who had surgery between 6 and 12 months of medical treatment versus those who had surgery after more than 12 months of medical treatment, this did not reach statistical significance. A prospective study with more patients may shed more light on this subject.     

鼻内镜下慢性蝶窦炎手术

目的：探讨经鼻内镜手术治疗慢性蝶窦炎的方法和疗效。方法：50例84侧慢性蝶窦炎患者，均采用鼻内镜手术治疗。结果：经6～12个月随访复查，根据内镜鼻窦手术疗效评定标准，治愈61侧，占72．62％；好转13侧，占15．48％；无效10侧，占11．90％；有效率为88．10％。结论：经鼻内镜手术治疗慢性蝶窦炎具有视野清楚，手术进路安全，创伤小，患者痛苦小，疗效好等优点。     

腺样体切除术对儿童慢性鼻窦炎的影响

目的:探讨腺样体切除术对儿童慢性鼻窦炎的影响.方法:慢性鼻窦炎患儿51例,其中单纯腺样体切除术17例,腺样体切除术加鼻窦开放术22例,单纯鼻窦开放术12例,术后随访6个月以上.结果:单纯腺样体切除组有效率88.2%,腺样体切除术加鼻窦开放组有效率100.0%,单纯鼻窦开放组有效率75.0%.腺样体切除术加鼻窦开放组和单纯鼻窦开放术组之间的有效率比较差异有统计学意义(P<0.05).结论;腺样体肥大与儿童慢性鼻窦炎发生密切相关,腺样体切除术是有效的辅助治疗措施.     

Endoscopic sinus surgery for unilateral chronic sinusitis]

Functional endoscopic sinus surgery has become an increasingly popular treatment for chronic sinusitis. This approach is aimed at re-establishment of ventilation and mucociliary clearance of the sinuses. However, some otolaryngologists believe that the Caldwell-Luc procedure should be routinely used for unilateral chronic sinusitis, because it is often associated with the maxillary sinus carcinomas. To evaluate the state of endoscopic sinus surgery for the diagnosis and treatment of unilateral chronic sinusitis, we analyzed the cases of 39 patients with unilateral chronic sinusitis who underwent endoscopic sinus procedures. These patients were unresponsive to appropriate antibiotic management for more than 6 months. Generally, endoscopic ethmoidectomy and antrostomy were performed with preservation of the middle turbinate. After the ostium was enlarged, the maxillary sinus was cleaned and carefully inspected for the presence of associated neoplasms using 30 and 70 degree endoscopes. Preoperative computed tomography (CT), postoperatve pathologic diagnosis, fiberscopic findings of the maxillary sinus, and symptomatic improvement were evaluated. Three patients had CT evidence of bone destruction of the lateral nasal wall. Pathological diagnosis demonstrated that three patients had maxillary sinus mycoses caused by Aspergillus species, one patient had inverted papilloma, and the other 35 patients had chronic sinusits. No associated malignancy was found. Eighty-one percent of the patients had almost normal endoscopic findings of the maxillary sinus by postoperative fiberscopic examination 4 to 8 months following surgery. With an average follow-up of 26 months, 88% of the patients were judged as having significantly improved in their presenting complaints of mucopurulent rhinorrhea, nasal obstruction, and facial pain. The results of this series suggest that endoscopic sinus surgery is an effective procedure for the diagnosis and treatment of unilateral chronic sinusitis.     

经鼻内窥镜手术治疗儿童慢性鼻窦炎疗效分析

目的：探讨功能性鼻窦内间手术治疗儿童慢性鼻窦炎的疗效及有关影响因素。方法：对１９９６年５月～１９９９年１月接受功能性鼻窦内窥镜手术并完成随访１年以上、有完整病历记录的儿童慢性鼻窦炎和鼻息肉患者３１例进行回顾性分析。结果：按照ＦＥＳＳ－９７海口疗效评定标准，３１例中治愈１２例（３８．７％），好转１５例（４８．４％），无效４例（１２．９％），总有效率为８７．１％，均无严重并发症发生。结论：经鼻内窥镜手     

老年人慢性鼻窦炎的鼻内镜手术治疗

目的:探讨鼻内镜手术治疗老年患者鼻息肉、慢性鼻窦炎的疗效。方法:对45例(76侧)≥65岁老年鼻息肉、慢性耳窦炎患者行鼻内镜手术的临床资料进行回顾性分析。结果:术后随访1年以上,总有效率93.3％(42/45),其中治愈率66.7％(30/45),好转率26.6％(12/45)。结论:鼻内镜手术同样适合于老年患者,可望提高老年患者的生存质量。     

鼻内窥镜手术治疗慢性鼻窦炎疗效评估的探讨

目的 探讨鼻内窥镜手术治疗鼻窦炎的疗效评估方法。方法 对１９９１￣１９９５年手术并随访１年以上的７２５例完整临床资料，按照本文作者参加设计的广州ＦＥＳＳ－９５疗效评估指标进行分析。结果 鼻窦病变性质，范围和严重程度的差别与手术疗效有显著相关性，７２５例中总治愈好转率Ｉ型：一期为１００％，二期为９７．３％，三期为８８．６％；Ⅱ型：一期为１００％，二期为８９．９％，三期为８７．１％；Ⅲ型为８０．６％。     

Efficacy of endoscopic sinus surgery in the management of patients with asthma and chronic sinusitis

An association between chronic sinusitis and asthma has been noted for many years, although the precise nature of the relationship is poorly understood. Earlier studies, using traditional surgical techniques, have demonstrated subjective improvement in asthmatic complaints. Reports demonstrating improvement following endoscopic sinus surgery for chronic sinusitis are rare. To report our experience with endoscopic sinus surgery and asthmatics, we reviewed the charts of 75 consecutive patients with asthma and chronic sinusitis who underwent endoscopic sinus surgery between 1994 and 1996. Study criteria included the following: chronic sinusitis, one year preoperative and one year postoperative follow-up from endoscopic sinus surgery, and asthma requiring inhaled steroids and oral prednisone for control. Many patients required prednisone bursts for control of asthma. Number of days and total dose of oral prednisone were used as objective measures of asthma control. Number of weeks of antibiotics was used as a relative measure of sinusitis. Fourteen of the 15 patients meeting study criteria decreased their postoperative prednisone requirement by total number of days (preoperative 84 versus postoperative 63 days [p < 0.0001]). Postoperatively, patients required an average of 1300 mg less oral prednisone (p < 0.033). Antibiotic use also decreased, with an average use of antibiotic nine weeks preoperatively versus seven weeks postoperatively (p < 0.045). This study provides corroborative objective evidence that, at least in the short term, endoscopic sinus surgery is efficacious in the management of patients with chronic sinusitis and asthma.