Development of Systematic Endoscopic Microsurgical Procedures in Endonasal Sinus Surgery

鼻内窥镜手术是治疗慢性鼻窦炎最合适的方法，因此在鼻科手术中越来越重要。然而，该手术被认为是一项需要特殊技能的高难度手术。在本课题中，我们对鼻窦内窥镜手术在慢性鼻窦炎手术中的应用进行了以下的探索和探索。(1)对40例(65侧)鼻内窥镜手术后慢性鼻窦炎的愈合过程进行了观察。结果显示，43%的患者完全治愈，结构和功能均保持不变，仅有少数患者无缓解。(2)在手术中引入内窥镜：为获得最可接受和最安全的使用方法进行探讨。最合适的内窥镜是直径4 mm、视角80度的硬质望远镜。外科医生应与之妥协，偶尔干扰手术操作。(3)引入电视转播系统：教育效果显著。(4)特殊的外科设备：进行显微外科手术，其特点是适当地保存黏膜。(5)计算机辅助鼻窦三维重建：有效地确定了单个鼻窦的空间方位。(6)鼻腔内手术的预防性手术措施：为防止延迟愈合和术后鼻窦开口阻塞而进行的研究。

Endonasal sinus surgery became increasingly important procedure in rhinological practice because it is the most appropriate therapeutic method for chronic sinusitis. This procedure, However, is ranked as a highly difficult surgery which needs a special skill.In this project, the following ersearch and investigations were made to establish systematic method in application of endoscopic sinus surgery for chronic sinusitis. (1) The healing process of chronic sinusitis after endonasal sinus surgery: Was investigated in our series of 40 cases (65 sides). The result showed that 43% were completely cured, maintaining both structure and function, and only a few cases showed no remission.(2) Introduction of endoscopes in surgery: Was investigated to obtain the most acceptable and safe employment. The most appropriate endoscope was found to be the rigid telescope of 4mm in diameter with 80 degree visual angle. Gthe surgeon should compromise with it to disturb surgical manipulation occasionally.(3) Introduction of televising system: Is much effective for education. The most efficient make was the Circon CCD TV camera with its beamsplitter.(4) Special surgical equipments: Were designed to perform microsugical proceddures which is characterized to preserve mucosa appropriately.(5) Computer-aided thiee-dimensional reconstrution of the sinuses: Was found to be efficient to establish the spatial orientation in the individual sinuses.(6) Precautionary surgical measures in endonasal sinus surgery: Were invastigated to prevent delayed healing and postoperatve obstruction of the opening of the sinuses.