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Objective To study the scanning technique of HRCT for demonstrating the anatomical structures of the frontal sinus and its drainage channels, including ostium of frontal sinus, nasofrontal duct, ethmoid infundibulum, middle nasal meatus, etc.

目的 探讨高分辨力CT扫描对额窦引流通道(鼻额管、额窦窦口、筛漏斗、中鼻道等)解剖结构的显示及其扫描技术。

The ostium of frontal sinus Positions should be divided into two type by the interaction of basal lamella of bulla and cribriform roof. TypeⅠ: The ostium of frontal sinus is located in lateral sinus, flows through superiorsemilunar hiatus to middle nasal meatus. It is about 20%. TypeⅡ: The ostium of frontal sinus is located in ethmoid infundibulum, frontal recess and its cell, flows through interior semilunar hiatus to middle nasal meatus. It is about 80%. Among them there are about 62.5% in ethmoid infundibulum, about 37.5% in frontal recess.

额窦鼻口的位置可根据筛泡基板与筛顶连接的情况划分为两种类型:Ⅰ型额窦的鼻口开口于侧窦,经上半月裂流入中鼻道,约占20%;Ⅱ型开口于筛漏斗、额隐窝及其气房,经下半月裂流入中鼻道,约占80%,其中开口于筛漏斗约为62.5%;开口位于额隐窝约为37.5%。

Results The total 100 frontal sinuses were all revealed. Of 100 ostia, nasofrontal ducts, ethmoid infundibula, and middle nasal meatuses, 4 didn't show up and 96 could be viewed with air channel and bone channel structures well demonstrated in 70, and the remaining 26 still showed their bone channel structures though their air channel structures were vanished.Conclusion The structures of the ostium of frontal sinus, nasofrontal duct, ethmoid infundibulum, middle nasal meatus, etc.

结果 50例被检查者的50个额窦全部显示;100个窦口、鼻额管、筛漏斗及中鼻道结构,4个未显示,96个被显示,其中70个窦口、鼻额管、筛漏斗及中鼻道的气道结构和骨结构均清晰可见,26个窦口、鼻额管、筛漏斗及中鼻道的气道结构消失但骨结构仍可见。

Treatment of 6 cases of traumatic cerebrospinal rhinorrhea in frontal sinus by intranasal endoscopic surgery was reported.

目的 探讨经鼻内窥镜外科治疗额窦脑脊液鼻漏的适应证、操作技巧及优点。

Objective To evaluate the indication, operative technique and advantages of the treatment of traumatic cerebrospinal rhinorrhea in frontal sinus by intranasal endoscopic surgery.

目的 探讨经鼻内窥镜外科治疗额窦脑脊液鼻漏的适应证、操作技巧及优点。

Methods Nasofrontal duct was extended and the bottom of frontal sinus was opened under nasal endoscope.

目的 观察筛窦切除术+额窦开放术与单纯筛窦切除术治疗慢性额窦炎的疗效方法在内窥镜下扩鼻额管,开放额窦底。

Methods 30 cases of nasal soft tissue de fects were reconstructed by different kinds of local flaps according to modified Burget′s nasal subunit. The Rintala flaps were used above the lowest level of low eyelids; at the area between low eyelids and the alar groove, the dorsal def ects were covered by ax-like local flaps and defects on side wall were reconstru cted by flaps rotated from the contralateral wall covered by skin graft; when it was below the highest level of alar groove, nasolabial flaps with subdermal ped ical were applied to nasal tip defection, and nasolabial local flaps to alar def ects, axial nasodorsum flaps supplied by the lateral nasal artery to defects inv olving columellae.

结合Burget鼻部美学分区,将其再分为三个区域,根据分区选用局部或邻位皮瓣修复鼻部各区软组织缺损30例(鼻根部以Rintala鼻额部局部皮瓣推进3例;鼻中段的鼻背部行双侧斧状局部皮瓣旋转3例;鼻侧壁行对侧壁局部皮瓣转移,供区植皮4例;鼻端部以鼻唇沟皮下蒂岛状瓣转移修复鼻尖部7例;鼻唇沟局部皮瓣旋转修复鼻翼部7例;鼻背轴型皮瓣旋转修复鼻小柱6例)。

Methods: The operation procedure included frustration and elevation of the nasal bone and part of the forntal process of maxilla and replacement of the nasal septum between greater alar cartilages.

本手术通过凿断鼻骨及部分上颌骨额突揿压折断使其耸立以抬高鼻背和移植自体鼻中隔软骨以增高鼻尖或鼻翼,一次性完成鼻外形的整体修复。

Measure the items on before and after the two courses of treatment respectively as follows:① Syndromes Investigation: to adopt the scoring methods of symptoms and signs with the certain standard scoring table of symptoms and classifying table of signs for the patients, on the day before and after the two courses of treatment respectively ,② Signs Investigation: the mucoma visibility, swelling or hyperemia conditions, or gloyp and polypoid change in the inferior and middle nasal conchas, nasal septum, etc with a nasal endoscope on the day before and after the two courses of treatment respectively,③ Test of the lung functiaon on the previous day before and after the two courses of treatment respectively.

治疗组在治疗前、两个疗程结束后分别进行以下项目的观察:①临床症状的评定:治疗前及两个疗程结束后当天对患者鼻塞、鼻痒、流涕、喷嚏症状的程度进行评分;②体征的评定:治疗前及两个疗程结束后当天采用鼻额镜肉眼观察患者下鼻甲鼻粘膜颜色、肿胀情况,及中鼻甲是否可见,有否息肉样变等;③治疗前及两个疗程结束后即刻予以检测肺功能。

Measure the items on before and after the two courses of treatment respectively (one course for 15 days) as follows:①Syndromes Investigation: to adopt the scoring methods of symptoms and signs with the certain standard scoring table of symptoms and classifying table of signs for the patients, on the day before and after the two courses of treatment respectively,②Signs Investigation: the mucoma visibility, swelling or hyperemia conditions, or gloyp and polypoid change in the inferior and middle nasal conchas, nasal septum, etc with a nasal endoscope on the day before and after the two courses of treatment respectively,③Test of the interferon-γ、interleukine-4(IL-4) in serum of patients by the method of enzyme linked immunosorbent assay on the previous day before and after the two courses of treatment respectively.

治疗组在治疗前、两个疗程结束后分别进行以下项目的观察:①临床症状的评定:治疗前及两个疗程结束后当天对患者鼻痒、鼻塞、流涕、喷嚏症状的程度进行评分;②体征的评定:治疗前及两个疗程结束后当天采用鼻额镜肉眼观察患者下鼻甲鼻粘膜颜色、肿胀情况,及中鼻甲是否可见,有否息肉样变等;③治疗前及两个疗程结束后一天清晨空腹抽取患者肘静脉血4ml离心后,采用酶联免疫吸附试验检测患者血清IFN-γ、IL-4的含量。

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