山东大学耳鼻喉眼学报 ›› 2021, Vol. 35 ›› Issue (1): 61-68.doi: 10.6040/j.issn.1673-3770.0.2020.208

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电磁导航引导筛窦球囊成形术精准治疗慢性筛窦炎10例

王再兴1,唐志元1,赵海亮1,刘智献1,李定波1,李胜1,马世博1,卢永田2   

  1. 1. 深圳市龙岗区耳鼻咽喉医院 耳鼻咽喉科/深圳市耳鼻咽喉研究所, 广东 深圳 518172;
    2. 深圳市第二人民医院/深圳大学第一附属医院 耳鼻咽喉科, 广东 深圳 518035
  • 发布日期:2021-02-01
  • 通讯作者: 卢永田. E-mail:luyongtian@263.net
  • 基金资助:
    深圳市医学重点学科建设经费资助(NOSZXK039)

Ten cases of chronic ethmoid sinusitis were accurately treated by electromagnetic navigation guided ethmoid sinus balloon angioplasty

WAGN Zaixing1, TANG Zhiyuan1, ZHAO Hailiang1, LIU Zhixian1, LI Dingbo1, LI Sheng1, MA Shibo, LU Yongtian2   

  1. 1. Department of Otolaryngology, Longgang E.N.T hospital & Shenzhen Key Laboratory of E.N.T, Institute of E.N.T Shenzhen, Shenzhen 518172, Guangdong, China;
    2. Department of Otorhinolaryngology, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen 518035, Guangdong, China
  • Published:2021-02-01

摘要: 目的 评价电磁导航引导下筛窦球囊成形术的手术效果。 方法 回顾分析符合手术适应证进行电磁导航引导筛窦球囊成形术(ENBS)和功能性鼻内镜手术(FESS)的20例慢性筛窦炎患者临床资料,并对两组患者手术前后视觉模拟量表(VAS)、鼻腔-鼻窦结局测试22条(SNOT-22)及Lund-Mackay CT评分(LMS)进行统计学分析。 结果 ENBS和FESS手术前后的VAS、SNOT-22及Lund-Mackay(CT)评分差异有统计学意义;ENBS和FESS在手术时间、手术出血量、术后上皮化恢复时间差异有统计学意义。 结论 ENBS和FESS对慢性筛窦炎均有良好疗效,两种术式治疗效果差异无统计学意义。通过导航引导下的ENBS较FESS术区定位精准、手术时间短、出血量少、创伤范围小、术后恢复时间短,ENBS治疗慢性筛窦炎更为精准。

关键词: 电磁导航, 慢性筛窦炎, 球囊窦成形术, 功能性鼻内镜手术, 视觉模拟量表(VAS), 鼻腔-鼻窦结局测试22条(SNOT-22), Lund-Mackay CT(LMS)评分

Abstract: Objective Evaluation of the surgical effect of using electromagnetic navigation guidance for balloon dilatation in ethmoid sinus surgery. Methods We retrospectively analyzed the clinical data of 20 cases of chronic sinusitis surgically treated with electromagnetic navigation balloon sinuplasty(ENBS)or functional endoscopic sinus surgery(FESS). We statistically analyzed the visual analog scale(VAS)score, the 22-item Sinonasal Outcome Test(SNOT-22)result, and Lund-Mackay score(LMS)before and after surgery. Results ENBS and FESS showed significant differences in the VAS score, SNOT-22 result, and LMS score before and after surgery as well as in surgery time, blood loss volume, and postoperative epithelial healing time. Conclusion ENBS and FESS for chronic sinusitis had good curative effects and showed no significant differences in the surgical treatment effect. However, ENBS enabled a more precise positioning of the scope, shorter operation time, lesser blood loss volume and trauma, and shorter postoperative recovery time compared to FESS.

Key words: Electromagnetic navigation, Chronic ethmoid sinusitis, Balloon sinuplasty, Functional endoscopic surgery, Visual analogue scale(VAS), 22-item Sinonasal Outcome Test, Lund-Mackay score(LMS)

中图分类号: 

  • R765.4
[1] Fokkens WJ, Lund VJ, Hopkins C, et al. European Position Paper on Rhinosinusitis and Nasal Polyps 2020[J]. Rhinology,2020,20(58):26-27. doi: 10.4193/Rhin20.600.
[2] 中华耳鼻咽喉头颈外科杂志编辑委员会鼻科组, 中华医学会耳鼻咽喉头颈外科学分会鼻科学组. 中国慢性鼻窦炎诊断和治疗指南(2018)[J]. 中华耳鼻咽喉头颈外科杂志, 2019, 54(2): 81-100. doi:10.3760/cma.j.issn.1673-0860.2019.02.001.
[3] Brown CL, Bolger WE. Safety and feasibility of balloon catheter dilation of paranasal sinus ostia: a preliminary investigation[J]. Ann Otol Rhinol Laryngol, 2006, 115(4):293-299. discussion 300-1. doi:10.1177/000348940611500407.
[4] 李明仙, 张永春, 张维天, 等. 球囊导管扩张术治疗慢性鼻-鼻窦炎失败原因分析[J]. 临床耳鼻咽喉头颈外科杂志, 2018, 32(5): 336-341. doi:10.13201/j.issn.1001-1781.2018.05.005. LI Mingxian, ZHANG Yongchun, ZHANG Weitian, et al. The possible failing reasons of balloon catheter dilation procedure in the management of chronic rhinosinusitis[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2018, 32(5): 336-341. doi:10.13201/j.issn.1001-1781.2018.05.005.
[5] 萧建新, 于青青, 唐隽, 等. 鼻窦球囊导管扩张术的远期疗效分析[J]. 山东大学耳鼻喉眼学报, 2012, 26(5): 38-42, 46. doi:10.6040/j.issn.1673-3770.2012.05.014. XIAO Jianxin, YU Qingqing, TANG Jun, et al. Long-term efficacy of balloon catheter sinusotomy[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2012, 26(5): 38-42, 46. doi:10.6040/j.issn.1673-3770.2012.05.014.
[6] 李晓明, 邸斌. 影像导航技术在鼻窦-颅底内镜手术中的应用[J]. 山东大学耳鼻喉眼学报, 2017, 31(2): 1-6. doi:10.6040/j.issn.1673-3770.0.2017.143. LI Xiaoming, DI Bin. Application of imaging navigation technique in the endoscopic sinonasal and skull base surgery[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2017, 31(2): 1-6. doi:10.6040/j.issn.1673-3770.0.2017.143.
[7] Eviatar E, Pitaro K, Gavriel H, et al. Complications following powered endoscopic sinus surgery: an 11 year study on 1190 patients in a single institute in Israel[J]. Isr Med Assoc J, 2014, 16(6): 338-340. PMID: 25058993.
[8] Dessi P, Castro F, Triglia JM, et al. Major complications of sinus surgery: a review of 1192 procedures[J]. J Laryngol Otol, 1994, 108(3): 212-215. doi:10.1017/s0022215100126325.
[9] 史广刚, 李秀国, 王招娣. 鼻内镜手术治疗慢性鼻窦炎和鼻息肉出现的严重并发症分析[J]. 中华耳鼻咽喉头颈外科杂志,2007,42(1):19-22.PMID: 17432351.
[10] Banks CA, Palmer JN, Chiu AG, et al. Endoscopic closure of CSF rhinorrhea: 193 cases over 21 years[J]. Otolaryngol Head Neck Surg, 2009, 140(6): 826-833. doi:10.1016/j.otohns.2008.12.060.
[11] McMains KC, Gross CW, Kountakis SE. Endoscopic management of cerebrospinal fluid rhinorrhea[J]. Laryngoscope, 2004, 114(10): 1833-1837. doi:10.1097/00005537-200410000-00029.
[12] Velasquez N, Thamboo A, Abuzeid WM, et al. Safe treatment of ethmoid sinusitis utilizing minimally invasive ethmoid punch sinusotomy in chronic rhinosinusitis without polyposis patients[J]. Laryngoscope, 2017, 127(6): 1268-1275. doi:10.1002/lary.26493.
[13] Abuzeid WM, Peterson AZ, Rathor A, et al. Enhanced Irrigant Delivery to the Ethmoid Sinuses Directly Following Ethmoid Punch Sinusotomy[J]. Ann Otol Rhinol Laryngol, 2017, 126(12):804-812. doi:10.1177/0003489417737323.
[14] 赖银妍, 许庚, 史剑波. 鼻窦球囊扩张术治疗慢性鼻-鼻窦炎[J]. 中华耳鼻咽喉头颈外科杂志, 2009, 44(1): 73-75. doi:10.3760/cma.j.issn.1673-0860.2009.01.018. LAI Yinyan, XU Geng, SHI Jianbo. The recent process in the treatment of chronic rhinosinnsitis: balloon sinuplasty[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2009, 44(1): 73-75. doi:10.3760/cma.j.issn.1673-0860.2009.01.018.
[15] Weiss RL, Church CA, Kuhn FA, et al. Long-term outcome analysis of balloon catheter sinusotomy: Two-year follow-up[J]. Otolaryngol Head Neck Surg, 2008, 139(3_suppl_1): S38-S46. doi:10.1016/j.otohns.2008.06.008.
[16] Kuhn FA, Church CA, Goldberg AN, et al. Balloon catheter sinusotomy: one-year follow-up: outcomes and role in functional endoscopic sinus surgery[J]. Otolaryngol Head Neck Surg, 2008, 139(3 Suppl 3): S27-S37. doi:10.1016/j.otohns.2008.05.010.
[17] Bolger WE, Brown CL, Church CA, et al. Safety and outcomes of balloon catheter sinusotomy: a multicenter 24-week analysis in 115 patients[J]. Otolaryngol - Head Neck Surg, 2007, 137(1): 10-20. doi:10.1016/j.otohns.2007.02.006.
[18] Rawlings BA, Han JK. Level of complete dissection of the ethmoid sinuses with a computed tomographic image guidance system[J]. Ann Otol Rhinol Laryngol, 2010, 119(1): 17-21. doi:10.1177/000348941011900103.
[19] Tschopp KP, Thomaser EG. Outcome of functional endonasal sinus surgery with and without CT-navigation[J]. Rhinology, 2008, 46(2): 116-120. PMID: 18575012.
[20] Minni A, Dragonetti A, Sciuto A, et al. Use of balloon catheter dilation vs. traditional endoscopic sinus surgery in management of light and severe chronic rhinosinusitis of the frontal sinus: a multicenter prospective randomized study[J]. Eur Rev Med Pharmacol Sci, 2018, 22(2): 285-293. doi:10.26355/eurrev_201801_14170.
[21] Soler ZM, Rosenbloom JS, Skarada D, et al. Prospective, multicenter evaluation of balloon sinus dilation for treatment of pediatric chronic rhinosinusitis[J]. Int Forum Allergy Rhinol, 2017, 7(3): 221-229. doi:10.1002/alr.21889.
[22] 张竞莹, 李赟, 韩卓琴, 等. 球囊扩张治疗慢性鼻窦炎的Meta分析[J]. 临床耳鼻咽喉头颈外科杂志, 2020, 34(5): 406-410, 416. doi:10.13201/j.issn.2096-7993.2020.05.005. ZHANG Jingying, LI Yun, HAN Zhuoqin, et al. Sinus balloon dilation for treatment of chronic sinusitis: a systematic review and Meta-analysis[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2020, 34(5): 406-410, 416. doi:10.13201/j.issn.2096-7993.2020.05.005.
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