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目的探讨后鼻孔息肉的临床类型、诊断及鼻内镜手术的方法和效果。方法总结1998年1月至2005年12月收治的34例后鼻孔息肉患者的临床资料,分析其发病方式、来源、临床表现、与鼻窦的关系以及鼻内镜手术技巧和疗效。结果①18例发病源于鼻窦囊肿或息肉,其中上颌窦17例,后筛窦1例;②5例发病分别源于鼻囟门或蝶筛隐窝、蝶窦口黏膜,同侧上颌窦或蝶窦积脓或黏膜水肿;③11例发病分别源于中鼻甲、钩突、嗅沟鼻中隔和筛泡前壁黏膜,邻近的鼻窦正常;④全部病例均行鼻内镜手术切除后鼻孔息肉及相应鼻窦开放,术后无复发。结论①建议诊断后鼻孔息肉应分为窦内型、鼻窦阻塞型和单纯型三种临床类型,遵循以临床类型为依据的手术原则,选择合理的术式和范围;②鼻内镜和鼻-鼻窦 CT 检查可以在术前明确后鼻孔息肉的诊断和临床类型;③鼻内镜手术治疗后鼻孔息肉准确、微创,彻底切除息肉蒂基部,防止复发。
Objective To investigate the clinical types, diagnosis and methods of endoscopic nasal polyps surgery. Methods The clinical data of 34 patients with posterior nosocomial polyps who were admitted from January 1998 to December 2005 were analyzed retrospectively. The incidence, source, clinical manifestations, relationship with sinuses, and techniques and effectiveness of endoscopic sinus surgery were analyzed. Results ① The etiology of 18 cases originated from sinus cyst or polyp, including 17 cases of maxillary sinus and 1 case of posterior ethmoid sinus. ② The incidence of 5 cases originated from the fontanel of fontanelle or butterfly, mucosa of sphenoid ostium, maxillary sinus or sphenoid sinus Pus or mucosal edema; ③ The incidence of 11 cases were originated from the middle turbinate, uncinate process, olfactory groove nasal septum and the anterior wall of the bubble, adjacent to the normal sinus; ④The nasal polyps and the corresponding sinus open in all cases after endoscopic sinus surgery, No recurrence after surgery. Conclusions ① The proposed diagnosis of nostril polyp should be divided into three types of sinus, obstruction and simple sinus type, follow the principle of operation based on clinical type, select a reasonable surgical procedure and scope; ② endoscopic and nasal - Sinus CT examination can be clear postoperative nostril polyps diagnosis and clinical type; ③ endoscopic sinus surgery after nostril polyps accurately, minimally invasive, radical resection of the base of polyps to prevent recurrence.