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目的:探讨中鼻甲部分切除对预防内窥镜鼻窦术后中鼻甲与鼻腔外侧壁粘连的意义。方法:对2002年1月～2002年11月间内窥镜鼻窦手术的87例临床资料进行总结和随访。其中施行中鼻甲前1/3部分切除者38例,并与49例保留者进行比较。结果:全体病例Ⅰ型1期两组均未发生粘连,但Ⅰ型2期、3期,Ⅱ型,Ⅲ型中,B 组(保留组)术后粘连发生率为53%,且与病情的严重程度相关。A 组(切除组)术后无粘连发生,随访未发现有干燥性鼻炎和萎缩性鼻炎,嗅觉也未见有明显的减退。结论:建议采用中鼻甲部分切除来避免中鼻甲与中鼻道外侧壁粘连时,应视是否有利于疾病治愈和最大可能维持鼻腔和鼻窦的生理状态而定。并且在内窥镜鼻窦手术中应尽可能防止中鼻甲失去稳定。
Objective: To investigate the significance of partial removal of middle turbinate to prevent the adhesion of middle turbinate to lateral wall of nasal cavity after endoscopic sinus surgery. Methods: Clinical data of 87 cases of endoscopic sinus surgery between January 2002 and November 2002 were summarized and followed up. Among them, 38 cases were performed in the first 1/3 part of middle turbinate and compared with 49 cases. Results: In all cases, no adhesion occurred in stage Ⅰ and stage Ⅰ, but in stage Ⅰ, stage Ⅱ, stage Ⅲ, stage Ⅱ and stage Ⅲ, the incidence of postoperative adhesions in group B (reserved group) was 53% Severity related. A group (resection group) no adhesions occurred after follow-up did not find a dry rhinitis and atrophic rhinitis, no significant decline in sense of smell. CONCLUSIONS: It is recommended that partial removal of the middle turbinate be used to avoid adhesion of the middle turbinate to the lateral wall of the middle nasal canal, depending on whether it is beneficial to the cure and the maximum possible maintenance of nasal and sinus physiology. And endoscopic sinus surgery should be as far as possible to prevent loss of stability in the middle turbinate.