内窥镜鼻窦手术与传统鼻窦手术对中鼻甲及嗅觉的影响

目的 :观察内窥镜鼻腔、鼻窦手术与传统鼻腔、鼻窦手术在慢性鼻窦炎、鼻息肉 ( 型 2期 , 型 2期 )中的手术疗效对中鼻甲形态及嗅觉的影响。方法 :对 1997年 9月～ 1999年 9月间参加该项研究并随访半年以上的二组病例 85例 (16 3侧 ) ,经冠状位鼻窦 CT扫描 ,术前、术后鼻内窥镜检查及嗅觉测试。二组分别施行内窥镜鼻腔、鼻窦手术及传统鼻腔、鼻窦手术 ,对中鼻甲病变采取完整保留和部分切除二类方式。结果 :经内窥镜鼻腔、鼻窦手术 ,随访半年以上的 5 2例(10 1侧 )患者鼻窦炎治愈、好转、无效率分别是 6 4.4%、2 9.7%、5 .9% ;相应中鼻甲恢复正常率分别是 6 3.1%、30 .0 %、0 .0 % ;嗅觉恢复正常率分别是 6 6 .2 %、36 .7%、0 .0 %。33例 (6 2侧 )经传统鼻腔、鼻窦手术患者鼻窦炎治愈、好转、无效率分别是 30 .6 %、48.4%、2 1.0 % ;相应中鼻甲恢复正常率分别是 47.4%、3.3%、0 .0 % ;嗅觉恢复正常率分别是 6 3.2 %、2 3.3%、0 .0 %。结论 :内窥镜鼻窦手术较传统鼻窦手术更有效地解决窦口鼻道复合体病变 ,从而提高 型、 型鼻窦炎治愈率。本研究表明中鼻甲形态的转归 ,嗅觉恢复与鼻窦炎治愈率有明显的相关性

The effects on morphology of middle turbinate and olfaction after endoscopic sinus surgery and conventional technique in sinus surgery

Objective: To observe the effects on morphology of middle turbinate and olfaction in trasnasal endoscopic sinus surgery and conventional technique in surgery in chronic sinusitis and nasal polyps (stage Ⅰ，Ⅱ)。 Methods: Two groups patients (85 cases, 163 sites) from September 1979 to September 1999 were examined by coronal CT scans of sinus, nasal endoscopy and olfctory test preoperative and postoperative. Of these patients, 52 cases (101 sites) were operated by transnasal endoscopic sinus surgery, 33 cases (62 sites) were operated by conventional technique in surgery respectively. Management of middle turbinate was divided into reserving and resecting two way. Results: In group of endoscopic sinus surgeries (52 cases, 101 sites), the rates of cure, improved and ineffective were 64.4% (65/101), 29.7%(30/101), 5.9%(6/101) respectively by following 6 months; and returning to normal rates of middle turbinate were 63.1% (41/65), 30.0% (9/30), 0.0% (0/6) respectively; and the returning to normal rates of olfaction were 66.2% (43/65), 36.7% (11/30),0.0%(0/6) respectively; the returning to normal of middle turbinate were 47.4%( 9/19),3.3%(1/13),0.0%(0/13) respectively; the returning to mormal rates of olfaction were 63.2%(12/19),23.3%(7/30),0.0%(0/13) respectively.Conclusion: Endoscopic sinus surgery for chronic sinusitis and nasal polyps can solve ostiomeatal complex anomalism more effectively and raise the cure rates of sinusitis (stage Ⅰ,Ⅱ) than conventional technique in surgery. The morphology middle turbinate and olfaction returned to normal affected directly sinusitis curative rate.