鼻内镜下经泪前隐窝入路成人上颌窦后鼻孔息肉切除术的应用分析
Application analysis of nasal endoscopic resection of antrochoanal polypsvia prelacrimal recess approach in adults
陈银 1俞晨杰 1高下1
作者信息
- 1. 210008 南京,南京大学医学院附属鼓楼医院耳鼻咽喉头颈外科,南京鼓楼医院耳鼻咽喉研究所
- 折叠
摘要
目的 评价鼻内镜下经泪前隐窝入路成人上颌窦后鼻孔息肉(ACP)切除术的应用价值.方法 回顾性分析2017 年 7 月至 2022 年 5 月南京鼓楼医院耳鼻咽喉科收治的 22 例上颌窦后鼻孔息肉患者的临床资料.行鼻内镜下经泪前隐窝入路上颌窦后鼻孔息肉切除术,其中 10 例保留中鼻道上颌窦自然引流口结构,12 例联合经中鼻道上颌窦口扩大.比较术前、术后 1 个月及术后 12 个月视觉模拟量表评分(VAS)、鼻腔鼻窦结局测试 22 量表(SNOT-22)、鼻内镜检查及鼻窦CT检查结果.结果 患者术后 1 个月及术后 12 个月 VAS、SNOT-22 症状评分较术前明显降低(P＜0.001),术后 12 个月 VAS、SNOT-22 症状评分较术后 1 个月明显降低(P＜0.001).随访 12 个月后,内镜结果显示所有患者均未出现鼻泪管损伤、鼻腔粘连等并发症.10 例保留中鼻道上颌窦自然引流口结构的患者与 12 例联合经中鼻道上颌窦口扩大患者术前及术后 12 个月复查CT显示,上颌窦腔内壁光滑,无炎症或息肉潴留,恢复好,均无复发.结论 应用鼻内镜下经泪前隐窝入路可安全有效地清除ACP,术后并发症少,随访期内无复发,并且保留中鼻道上颌窦自然引流口结构能够获得与联合切除钩突并开放扩大上颌窦口同样的疗效.
Abstract
Objective To assess the clinical value of nasal endoscopic resection of antrochoanal polyps(ACP)using the prelacrimal recess approach in adults.Methods Between July 2017 and May 2022,22 patients with ACP at the Department of Oto-rhinolaryngology,Nanjing Drum Tower Hospital were enrolled.All patients underwent nasal endoscopic resection of ACP via the prelacrimal recess approach.Ten cases preserved the natural drainage structure of the middle meatus,while 12 cases had an enlarged ostium of the maxillary sinus.Visual Analogue Scale(VAS),sino-nasal out-come test 22(SNOT-22),nasal endoscopy and sinus CT were com-pared before surgery,1 month and 12 months after surgery.We com-pared preoperative and postoperative(at 1 month and 12 months)re-sults of the VAS,the SNOT-22,nasal endoscopy,and sinus CT scans.Results The VAS and SNOT-22 scores of patients 1 month and 12 months after surgery were significantly lower than those before surgery(P＜0.001),and the VAS and SNOT-22 scores of patients 12 months after surgery were significantly lower than those 1 month after surgery(P＜0.001).At the 12month follow-up,endoscopic results indicated no complications such as nasolacrimal duct damage or nasal adhesions in any patient.CT reexamination before and 12 months after operation showed that the inner wall of the maxillary si-nus cavity was smooth,without inflammation or polyp retention,and no recurrence in 10 patients with the natural drainage of maxillary sinus in the middle nasal canal and 12 patients with combined expansion of maxillary sinus through the middle nasal canal.Conclusion The application of nasal endoscopic resection of antrochoanal polypsvia prelacrimal recess approach can safely and effec-tively remove ACP,with fewer postoperative complications and no recurrence during the follow-up period.In addition,retaining the structure of the natural maxillary sinus drainage in the middle nasal canal can achieve the same curative effect as the combined removal of the uncinate process and opening and expanding the maxillary sinus opening.
关键词
上颌窦/息肉/鼻内镜/泪前隐窝Key words
maxillary sinus/polyp/nasal endoscope/prelacrimal recess引用本文复制引用
基金项目
江苏省医学重点学科建设项目(ZDXKB2016015)
南京市卫生科技发展专项(YKK20070)
南京医科大学教育研究课题(2021)(2021ZC078)
出版年
2024
NETL
NSTL
万方数据