内窥镜鼻窦手术治疗鼻窦炎、鼻息肉复发原因探讨

目的 :探讨内窥镜鼻窦手术治疗鼻窦炎、鼻息肉复发的原因 ,提高手术疗效。方法 :回顾性分析内窥镜鼻窦手术治疗鼻窦炎、鼻息肉复发的临床病例 38例。结果 :因鼻腔上部处理不彻底引起复发者 13例 ,中鼻甲息肉及中鼻甲外粘连至复发者 12例 ,上颌窦口阻塞引起者 4例 ,上颌窦内息肉未摘除干净者 3例 ,高位鼻中隔偏曲未行矫正阻塞中鼻道引起复发者 3例 ,其他原因者 3例。结论 :熟悉内窥镜鼻窦手术的应用解剖 ,熟练的手术操作技巧 ,特别是对几个容易引起复发的部位的处理得当 ,以及术后定期合理的鼻窦内窥镜随访是预防和减少复发的重要因素。

Investigation of the causes of the recurrent nasal polyps in patients with rhinosinusitis after endoscopic surgery

Objective: To investigate the causes of the recurrent nasal polyps in patients with rhinosinusitis after endoscopic surgery and the problems of operative technique, classification and the management of postoperative were discussed. Methods: The clinical data of 38 patients with rhinosinusitis who had recurrent nasal polyps after endoscopic surgery were retrospected. Results: The causes of recurrent nasal polyps were incomplete remove of the upper nasal cavity in 13, adhesion of the middle turbinat in 12, obstruction of the maxillary sinus in 4, incomplete section of the polyps in maxillary sinus in 3, the deviation of the upper nasal septum in 3 and unknown in 3. Conclusion: Good knowledge of the functional anatomy of the endoscopic surgery, good endoscopic surgery skills, proper polyps section for the high site, extensive postoperative care and patients follow|up are the important factors to prevent or reduce the recurrence of the nasal polyps.