廣泛性息肉樣上頜竇炎經鼻竇功能性內視鏡手術後之臨床評估

Clinical Evaluation of Diffuse Polypoid Maxillary Sinusitis After Functional Endoscopic Sinus Surgery

劉嘉銘(Chia-Ming Liu) ； 葉德輝(Te-Huei Yeh) ； 徐茂銘(Mow-Ming Hsu)

《中華民國耳鼻喉科醫學會雜誌》 27卷4期 (1992/12) Pp. 322-327

https://doi.org/10.6286/1992.27.4.322

摘要

為了探討鼻竇功能性內視鏡手術後，上頜竇粘膜功能恢復的情況，我們選擇了10名病人計20側有廣泛性息內樣鼻-鼻竇病變 (diffuse polypoid rhinosinopathy)的上頜竇，觀察其在前篩竇已經通暢的情況下粘膜恢復的情形。在觀察6個月以後，6側 (30%) 痊癒，其餘14側 (70%) 仍有廣泛性或局限性息肉樣病變，且半數仍有粘膿液分泌。我們認為對於此類嚴重的上頜竇粘膜病變，應在功能性手術的原則下再採取較積極但有限度的處置，因為鼻竇粘膜病變除了和開口之通暢與否有關之外，其他的因素如支配粘膜的血管、神經系統、粘膜的免疫功能等亦可能都有關係。

關鍵字

鼻竇功能性內視鏡手術 ； 廣泛性鼻-鼻竇息肉樣病變

並列摘要

Functional endoscopic sinus surgery (FESS) for chronic sinusitis has been popularized in substitution for the radical operations since the great work of Messerklinger in 1967 which demonstrated the anterior ethmoids to be usually the key to persistent sinusitis was appreciated. We selected 10 patients with bilateral diffuse polypoid rhinosinopathy admitted for FESS and followed for at least 6 months for study. The recovery of these twenty maxillary sinuses was inspected by endoscopy through the enlarged middle meatal antrostomies. We found that six sinuses recovered, six still had diffuse polypoid change and another eight had focal polypoid change. Mucopurulent discharge from nine sinuses was noted in six with diffuse polypoid change and three with focal polypoid change. We conclude that for diffuse polypoid rhinosinopathy, limited manipulation of the maxillary polypoid mucosa is necessary, and that the recovery of the polypoid mucosa depends on not only the patency of the sinus ostia but also other factors such as local mucosal immune function and neurovascular system.

並列關鍵字

functional endoscopic sinus surgery ； diffuse polypoid rhinosinopathy