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目的:探讨应用Wormald技术行额隐窝开放术的方法及疗效。方法:对20例(24侧)慢性额窦炎患者应用Wormald技术行额隐窝开放术,术前鼻窦CT尤其是矢状位重建明确病变范围、来源及其与重要结构的毗邻关系。结果:所有患者术后均随访6个月以上,平均9个月,手术有效率为90%。除2例术后复发再次手术外,余未见复发。结论:鼻内镜下应用Wormald技术行额隐窝开放术安全可行,未见颅内、眼眶等严重并发症。术前明确定位导致额隐窝阻塞的病变气房;遇到难以辨认的额窦和额隐窝,应意识到手术的潜在困难;术中注意保护隐窝口黏膜;术后加强换药、冲洗、氧喷雾治疗,以提高手术疗效。
Objective: To explore the method and curative effect of forehead open surgery with Wormald technique. Methods: 20 cases (24 sides) of chronic frontal sinusitis were treated with Wormald technique and the preoperative sinusoids, especially sagittal reconstruction, were used to determine the extent and origin of the lesion and its adjacent relationship with the important structures. Results: All patients were followed up for 6 months or more, an average of 9 months, the operative efficiency was 90%. In addition to two cases of recurrence after surgery again, I did not see recurrence. CONCLUSIONS: Endoscopic sinus surgery with Wormald technique is safe and feasible, with no serious intracranial or orbital complications. Preoperative clear positioning leads to the frontal recess obstruction of the air room; encounter unrecognizable frontal sinus and frontal recess, should be aware of the potential difficulties of surgery; intraoperative attention to protect the crypt mucosa; postoperative to strengthen the dressing, washing , Oxygen spray treatment to improve the surgical effect.