鼻内镜下Draf Ⅱ-Ⅲ型额窦开放手术在颅脑外伤术后反复额窦感染并窦道形成中的应用
Application of nasal endoscopic Draf Ⅱ-Ⅲ frontal sinus surgery in recurrent frontal sinus infection and sinus formation after craniocerebral trauma
吕操 1黄晓斌 2陈杰 1兰忠 1涂艺 1杨晓红 1白忠1
作者信息
- 1. 昆明医科大学第二附属医院耳鼻咽喉科,云南 昆明 650101
- 2. 昆明医科大学第二附属医院神经外科,云南 昆明 650101
- 折叠
摘要
目的 探讨鼻内镜下Draf Ⅱ-Ⅲ型额窦开放手术在颅脑外伤术后反复额窦感染并窦道形成中的应用.方法 8例颅脑外伤术后反复额窦感染的患者,主要表现为头痛、额部反复感染、流脓、窦道形成,发病时间平均43.25个月.患者在鼻内镜下行Draf Ⅱ-Ⅲ型额窦开放术,其中Draf Ⅱa型2例,Draf Ⅱb型5例,Draf Ⅲ型1例,术中扩大开放额窦口,见额窦内有骨蜡堵塞额窦口,取出骨蜡,额窦引流通畅.全部患者未做面部切口.结果 术后8例患者额部感染明显减轻,治愈出院,术中、术后未发生脑脊液鼻漏或颅内感染.出院后,于1、3、6、12个月进行门诊随访复查,见额窦口保持通畅,额部未再发生感染,瘘口逐渐愈合.结论 鼻内镜下采用Draf Ⅱ-Ⅲ型额窦开放术式,是处理颅脑外伤术后额窦反复感染并窦道形成的有效手术方式.
Abstract
OBJECTIVE To investigate the application of endoscopic Draf Ⅱ-Ⅲ frontal sinus surgery in the treatment of recurrent frontal sinus infection and fistula formation after craniocerebral trauma.METHODS There were 8 cases of recurrent frontal sinus infection after craniocerebral trauma,the main manifestations were headache,recurrent frontal infection,discharge of pus,fistula formation.The average onset time was 43.25 months.The patients underwent DRAF Ⅱ-Ⅲ frontal sinus surgery under nasal endoscopy,including Draf Ⅱa 2,Draf Ⅱb 5,and Draf Ⅲ1,respectively.During the operation,the frontal sinus ostium was expanded.It was found that bone wax blocked the frontal sinus ostium in the frontal sinus.The bone wax was removed,and the frontal sinus drainage was smooth.No facial incision was made in all patients.RESULTS There were 8 patients with frontal infection who were cured after surgery.No cerebrospinal fluid rhinorrhea or intracranial infection occurred during or after operation.After discharge,the outpatient follow-up review was conducted in 1,3,6,and 12 months.It was found that the frontal sinus remained unobstructed.The frontal sinus did not become infected again,and the fistula gradually healed.CONCLUSION Draf Ⅱ-Ⅲ frontal sinus surgery under nasal endoscopy is an effective way to treat recurrent frontal sinus infection and fistula formation after craniocerebral trauma.
关键词
内窥镜检查/鼻窦炎/额窦/颅脑损伤/感染Key words
Endoscopy/Sinusitis/Frontal Sinus/Craniocerebral Trauma/Infection引用本文复制引用
出版年
2024
国家科技期刊平台
NSTL
万方数据