Endoscopic Sinus Surgery for Complicated Paranasal Sinusitis

鼻竇炎併發症之內視鏡鼻竇手術

江榮山(Rong-San Jiang) ； 吳尚衡(Shang-Heng Wu) ； 許振益(Chen-Yi Hsu)

《中華民國耳鼻喉科醫學雜誌》 36卷4期 (2001/06) Pp. 218-224

https://doi.org/10.6286/2001.36.4.218

摘要

背景：雖然鼻竇炎併發症已經日益少見，但仍然時有所見。當一個鼻竇炎併發症有潛在的致死性或內科療法無效時，可能需要利用外科來引流被感染的鼻竇。
方法：從1992年起，本科開始使用內視鏡鼻竇手術來治療鼻竇炎併發症。利用病歷回顧來探討病患的臨床表現及治療步驟並用電話詢問術後鼻竇鼻腔症狀及併發症之復原來追蹤病患的預後。
結果：至1998年共有15名病患因鼻竇炎併發症而在本科接受內視鏡鼻竇手術治療。發生眼眶併發症(第一期至第四期)有11名，發生顱內併發症有4名，發生臉頰併發症有4名。除了內視鏡鼻竇手術，其中6名病患另外也接受其他的手術。3名病患接受眼眶切開手術，1名病患接受Lynch手術，1名病患接受開顱手術，1名病患接受臉頰膿包引流手術。14名病患平均追蹤38.4月後，9名病患已完全康復。3名病患偌有鼻竇症狀，但較手術前改善。另2名病患雖然並無鼻竇症狀，其中1名病患右眼仍失明，1名病患左眼仍失明且合併左臉頰麻痺.
結論：當合併併發症之鼻竇炎需要外科引流時，除了傳統手術外內視鏡鼻竇手術也可用來引流感染的鼻竇。

關鍵字

合併併發症之鼻竇炎 ； 內視鏡鼻竇手術

並列摘要

BACKGROUND: Although the complications of sinusitis have decreased, cases of complicated sinusitis continue to present. When a complicated sinusitis is potentially fatal or fails medical treatment, surgical drainage of the infected sinuses is indicated.
METHODS: Since 1992, our department has employed endoscopic sinus surgery (ESS) to treat acute complicated sinusitis. A review of files was undertaken to analyze both clinical manifestations and treatment procedures. The outcomes for these patients were evaluated by telephone, determining post-ESS sinonasal symptoms and sequelae.
RESULTS: Fifteen patients with complicated sinusitis were treated with ESS at our institution up to 1998. Orbital complications (Stage I-IV) occurred in 11 patients, intracranial complications in four patients, and cheek swelling in four patients. Other operative procedures in addition to ESS were undertaken in six patients. Orbitotomy was performed in three patients, Lynch’s operation in one patient, craniotomy in one patient, and drainage of a cheek abscess in one patient. No other sinus operations apart from ESS were performed in these patients. After a mean follow-up period of 38.4 months for 14 patients, nine patients remained asymptomatic. Nasal symptoms, albeit improved, persisted in three patients. Although the remaining two patients had no nasal symptoms, one patient’s right eye remained blind, and the other suffered form left eye blindness and left facial palsy.
CONCLUSIONS: When surgical drainage is indicated for a complicated sinusitis, in addition to traditional procedures ESS is an option available for drainage of the infected sinuses.

並列關鍵字

complicated sinusitis ； endoscopic sinus surgery