Development of Systematic Endoscopic Microsurgical Procedures in Endonasal Sinus Surgery

鼻内鼻窦手术是治疗慢性鼻窦炎最合适的方法，在鼻窦外科实践中日益重要。然而，这一手术被列为一项高难度的手术，需要一项特殊的技能。本项目进行了以下研究和调查，以建立系统的方法，在内窥镜鼻窦手术的应用慢性鼻窦炎。(1)慢性鼻窦炎经鼻内窥镜鼻窦手术后的愈合过程：在我们的系列研究40例（65侧）。结果表明，43%的患者完全治愈，结构和功能均得到维持，仅有少数患者无缓解。(2)在手术中引入内窥镜：进行了调查，以获得最可接受和最安全的就业机会。最合适的内窥镜是直径4mm、视角80 °的刚性镜。外科医生应与之妥协，偶尔干扰手术操作。(3)电视系统的介绍：对教育非常有效。最有效的制作是带有分束器的Circon CCD电视摄像机。(4)特殊手术设备：设计用于执行显微外科手术，其特征在于适当地保留粘膜。(5)计算机辅助鼻窦三维重建：被认为是有效的，以建立在个别鼻窦的空间方向。(6)鼻内鼻窦手术的预防性手术措施：为防止术后窦口梗阻和愈合延迟，我们进行了预防性手术。

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.