经鼻内镜囊肿造袋术治疗鼻窦黏液囊肿的临床研究

目的 探讨经鼻内镜囊肿造袋术治疗鼻窦黏液囊肿的临床疗效，并研究鼻窦黏液囊肿组织的超微结构及与病理特性之间的关系，为鼻寞黏液囊肿造袋术提供理论依据。方法 30例鼻窦黏液囊肿病人均行经鼻内镜囊肿造袋术，手术后标本作电镜超微结构检查。结果 术后随访6～12月无1例复发。30例均为黏液囊肿，除1例为立方状上皮外，其余内衬上皮为假复层纤毛柱状上皮。上皮纤毛发达，线粒体丰富，内质网、高尔基氏体发达，黏液性腺细胞和杯状细胞浆中有大量黏液分泌颗粒，基底膜下有大量淋巴细胞、中性粒细胞及少量嗜酸性粒细胞浸润。结论 经鼻内镜囊肿造袋术是治疗鼻窦黏液囊肿的有效术式，具有微创、面部无瘢痕等优点。鼻窦黏液囊肿内衬上皮与鼻腔大部分黏膜一样均为假复层纤毛柱状上皮，纤毛发达，术后纤毛功能可以恢复，其超微结构与病理特性密切相关。

Clinical study of marsupialization for treating mucocele of nasal sinus under nasal endoscope

[Objective] To explore the effect of Marsupialization on mucocele of nasal sinus under nasal endoscope, and study the ultrastructure of mucocele of nasal sinus. [Methods] Marsupialization were chosen for 30 cases of mucolece of nasal sinus under endoscope. After the operation the sample received pathological examination under electronic microscope. [Results] The follow-up time is from 6 months to 12 months. No one case recurred. The epithelia of 29 cases are pseUdostratified ciliated columnar epithelium. The cilium is prosperous, the mitochondrion is rich, and the endoplasmic reticulum and the Golgi complex are developed. There are a lot of secretory granule in goblet cell and mucous glandular cell, and there are many lymphocytic cells, neutmphilic granulocyte and a small quantity of eosinophilic granulocytcs. No one case recurred. [Conclusions] Marsupialization is a kind of effective operation to treat mucolece of nasal sinus. The epithelia of both mucocele and nasal mucosa is the same pseudostratified ciliated columnar epithelium, rich cilium in mucocele and the function of cilium could recover.