论文部分内容阅读
以往的观点认为,小儿慢性鼻窦炎的治疗应尽量避免手术.因为传统的外科手术难免会影响小儿颌面与牙胚的发育,破坏其鼻腔、鼻窦的生理功能,疗效亦不满意.鼻窦内窥镜手术(endoscopic sinussurgery,ESS)成功地用于治疗成人鼻腔、鼻窦疾病的经验,使人们重新探讨对药物治疗无效的小儿慢性鼻腔、鼻窦疾病外科手术治疗的可行性.对小儿不同发育时期鼻腔、鼻窦解剖学的详细研究,及对鼻窦炎发病机理和病理生理学的重新认识,为ESS治疗小儿鼻腔、鼻窦疾病提供了可靠的理论依据,并使ESS治疗逐步成为可能.本文试就ESS治疗小儿鼻腔、鼻窦疾病的现状作一综述,以供同道们参考.1 ESS适应证据Wolf等对1～12岁小儿的干颅骨94具、尸头8具的鼻腔、鼻窦进行观察,证明其前后组筛窦、中鼻道、钩突、半月裂和筛漏斗已经发育.因此,在内窥镜下对上述部位行ESS是可行的.手术适应证的选择:①窦口鼻道复合体阻塞:如筛泡肥大,中道粘膜肥厚、息肉样变.中鼻甲息肉样变等,选择钩
In the past view, the treatment of chronic sinusitis in children should be avoided as far as possible because traditional surgical operation will inevitably affect the development of children’s maxillofacial and tooth germ, destroying the physiological function of nasal and sinus, the effect is not satisfied. The successful experience of endoscopic sinussurgery (ESS) in the treatment of adult nasal and sinus diseases has re-explored the feasibility of surgical treatment of children with chronic nasal and sinus diseases that are ineffective in drug treatment.For children with nasal cavity, Detailed study of sinus anatomy, and re-understanding of the pathogenesis and pathophysiology of sinusitis provide a reliable theoretical basis for the treatment of nasal and sinus diseases in children with ESS, and make it possible to gradually ESS treatment.This article is about ESS treatment of children’s nasal cavity , Sinus status of the disease for a review for the fellow reference.1 ESS adapt to the evidence Wolf and other children aged 1-12 years in the dry skull 94, 8 cadaver nose and sinus were observed to prove that the anterior ethmoidal sinus , And the middle nasal passages, the uncinate process, the half-meniscus, and the sieve funnel have been developed, therefore, it is feasible to perform ESS on the above-mentioned site under the endoscope. Choice of evidence: ① sinus ostiomeatal complex obstruction: such as sieve hypertrophy, middle mucosal hypertrophy, polypoid change. Turbinate polypoid change, etc., select the hook