Endoscopic endonasal transseptal approach for localized sphenoid sinus diseases
Endoscopic endonasal transseptal approach for localized sphenoid sinus diseases
复制标题
DOI：
10.1016/j.anl.2008.09.008
复制
发表时间：
2009-08-01
影响因子：
1.7
通讯作者：
Gyo, Kiyofumi
中科院分区：
文献类型：
--
作者：
Hinohira, Yasuyuki;Hyodo, Masamitsu;Gyo, Kiyofumi
目的：局限性蝶窦病变的手术方法有多种。直接（经鼻）和间接（经筛窦）入路是鼻内镜下鼻窦手术（ESS）的常用方法，因为它们安全有效。然而，由于解剖变异、术后变化或其他原因，鼻窦的识别或治疗有时很困难。在这种困难的情况下，我们目前使用内窥镜鼻经中隔入路（EETA）蝶窦。适应症，程序，和这种手术方法的结果是presentedhere.Patients和方法：6 11例局部蝶窦疾病（足菌肿，n = 1，粘液囊肿，n = 5）使用EETA治疗。所有受试者均在局部麻醉下进行手术。在内窥镜常规鼻中隔成形术后，通过鼻中隔成形术伤口穿透前壁打开蝶窦。结果：使用EETA手术的患者无手术并发症或疾病复发，无需使用导航或透视系统。患者的平均随访时间为27.7个月（范围18-48个月）。后续管理包括内窥镜检查和计算机断层扫描。结论：一个经中隔的方法，蝶窦唇下切口曾经经常进行垂体手术。我们改良了经中隔入路，即使用内窥镜和鼻内切口的EETA。该入路是鼻内窥镜手术的一种实用、可靠的方法，可作为难治性蝶窦疾病的一种替代方法。EETA可以在办公室进行，因为它可以在局部麻醉下实现，而无需导航系统。(C)2008爱思唯尔爱尔兰有限公司保留所有权利。
Objective: Surgery for localized sphenoid sinus disease can be performed in different ways. Direct (transnasal) and indirect (transethmoidal) approaches are now prevalent in endoscopic endonasal sinus surgery (ESS) because they are safe and effective. However, the identification or treatment of a sinus is occasionally difficult due to the anatomical variation, postoperative changes, or other reasons. In such difficult cases, we currently used an endoscopic endonasal transseptal approach (EETA) to the sphenoid sinus. The indications, procedures, and outcomes of this surgical method are presented here.Patients and methods: Six of 11 patients with localized sphenoid sinus disease (mycetoma, n = 1; mucocele, n = 5) were treated using EETA. Surgery was performed under local anesthesia in all subjects. Following endoscopic conventional septoplasty, the sphenoid sinus was opened by perforating the anterior wall through the septoplasty wound. The sphenoid disease was treated through this opening, and then drained to the nasal cavity.Results: The patients operated on using EETA had no surgical complications or disease recurrence, and the use of navigation or fluoroscopy systems was not required. The mean follow-up period of the patients was 27.7 months (range 18-48 months). Follow-up management included endoscopic examination and computed tomography.Conclusions: A transseptal approach to the sphenoid sinus with a sublabial incision was once frequently performed in pituitary surgery. We modified the transseptal approach as EETA with the use of an endoscope and endonasal incision. This approach is practical and reliable for ESS, and may serve as an alternative for difficult-to-manage sphenoid sinus disease. EETA can be performed in the office as it can be achieved under local anesthesia without a navigation system. (C) 2008 Elsevier Ireland Ltd. All rights reserved.