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本文作者于1976年首先提出在儿童中用手术显微镜经鼻作鼻窦手术。其后并设计了能固定于手术台的前鼻孔扩张器,以后又出现了不挡术者视线的Flamingo 氏筛窦钳。几十年来筛窦开放已是一种治疗慢性鼻窦感染和息肉的常用手术,但它仍是用单眼检视、难以应用精细手术器械操作的“盲目性”手术,教学困难,加之蝶-筛解剖复杂、变异大,手术时易于引起颅脑和眼眶等并发症,从而使许多手术趋于保守,甚至避免施行。本文目的在于介绍把手术显微镜进一步用于比较困难的鼻内筛窦手术和蝶-筛窦手术。术前采集详细病史和进行鼻内检查;常规照Waters及Caldwell 位相,必要时加照筛窭斜位,张口蝶窦位、侧位及颏顶位等,鼻窦断层摄影和CT扫描更为精确。有异常鼻分泌物者,应常规作细胞学检查。软或硬管的鼻镜检查有特殊裨益。慢
In 1976, the author first proposed nasal sinus surgery in children using a surgical microscope. Subsequently, a front nostril dilator that can be fixed to the operating table was designed and Flamingo’s ethmoidal sinus pliers were also introduced later. Ethmoid sinus opening has been a commonly used treatment for chronic sinus infections and polyps for decades. However, it is still a “blind” operation with monocular viewing, which makes it difficult to apply fine surgical instruments. Teaching difficulties, combined with butterfly-screen dissection , Large variation, easy to cause complications such as brain and orbit when surgery, so that many operations tend to be conservative, and even avoid the implementation. This article aims to introduce surgical microscopy for further intranasal ethmoidectomy and butterfly-ethmoid sinus surgery. Preoperative collection of detailed history and intranasal examination; routine according to Waters and Caldwell phase, if necessary, plus screen sphygmomaniacs, mouth spreader, lateral and top of the genitals, sinusography and CT scan more accurately. Abnormal nasal secretions, should be routine for cytology. Noseoscopy of soft or hard tubes is of special benefit. SLOW