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经鼻的筛窦和蝶窦手术是治疗鼻息肉和慢性鼻窦炎较好的方法,却有灾难性的并发症。早在1929年Mosher就指出,“从理论上讲,鼻内筛窦切除术是容易的,而实践中却是最易致死的手术之一”。近10多年来文献报道,鼻内筛窦手术并发症发生率为0.9～2.8%,其中以脑膜炎、脑脊液漏和出血(需输血及延长住院时间)为常见,其它有单或双眼失明、眼外肌损伤或永久性眼球固定、额叶损伤致死、颈内动脉海绵窦瘘、大脑前动脉损伤、继发性额窦粘液囊肿等。本文作者报告2例筛窦手术分别损伤额叶及大脑前动脉,均经多次开颅术等处理才得救,但仍遗留永久性神经障碍。认为
Nasal ethmoid and sphenoid sinus surgery is a better method for the treatment of nasal polyps and chronic sinusitis, but there are catastrophic complications. As early as 1929, Mosher pointed out that “in theory, intramasophageal resection is easy, but in practice it is one of the most lethal surgery.” Reported in the literature over the past 10 years, intranasal ethmoid sinus surgery complications rate of 0.9 to 2.8%, of which meningitis, cerebrospinal fluid leakage and bleeding (blood transfusion and prolonged hospital stay) is common, other blind or single eyes, eyes External muscle injury or permanent fixation of the eye, frontal injury, cavernous fistula, anterior cerebral artery injury, secondary frontal sinus mucinous cyst. The authors report that 2 cases of ethmoid sinus surgery, respectively, frontal lobe damage and anterior cerebral artery were treated by multiple craniotomy was saved, but still left a permanent neurological disorder. think