PDF(Pubmed)
Abstract：
OBJECTIVE: The frontal sinus remains a challenging site for irrigation due to its position relative to the nostril and ethmoid sinus. This study aims to summarize the necessary factors for efficient irrigation of the frontal sinus after endoscopic sinus surgery (ESS) among patients with chronic rhinosinusitis (CRS).
METHODS: Using Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, a systematic literature review was conducted on PubMed, Scopus, and Cochrane databases to identify studies assessing the effect of frontal sinus irrigation in patients with CRS, cadaver models, or 3D-printed models of the sinonasal cavity after ESS.
RESULTS: Of the initial 206 abstracts reviewed, 18 full-text articles were included. The degree of the frontal sinus ostium opening after ESS was found to be associated with the efficacy of frontal sinus irrigation. More extensive frontal sinus surgeries tended to increase frontal sinus penetration. A Draf IIA procedure was identified as the minimum standard to achieve sufficient irrigation in the frontal sinus. Due to decreased backpressure in the nasal passage, increasing septectomy in Draf III did not significantly improve irrigation delivery. Squeeze bottles achieved significantly higher irrigation flow in the frontal sinus than syringes and pulsating devices. Large-volume irrigation devices provided better irrigation for the frontal sinus by entering or flushing the entire frontal sinus. The head position influenced the frontal sinus irrigation by altering the ostia position relative to fluid flow and vertical height of the frontal sinus during irrigation. While the vertex down head position was likely to enhance frontal sinus irrigation, the comfort of the head position and patient compliance should be considered.
CONCLUSIONS: Elements for optimization of frontal sinus irrigation are a minimum of a Draf IlA procedure for frontal sinus dissection, use of large-volume irrigation, and vertex down head positioning. Developing comfortable head positions with high frontal sinus irrigation efficiency would increase patient compliance and improve outcomes.
UNASSIGNED: NA.
METHODS: Using Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, a systematic literature review was conducted on PubMed, Scopus, and Cochrane databases to identify studies assessing the effect of frontal sinus irrigation in patients with CRS, cadaver models, or 3D-printed models of the sinonasal cavity after ESS.
RESULTS: Of the initial 206 abstracts reviewed, 18 full-text articles were included. The degree of the frontal sinus ostium opening after ESS was found to be associated with the efficacy of frontal sinus irrigation. More extensive frontal sinus surgeries tended to increase frontal sinus penetration. A Draf IIA procedure was identified as the minimum standard to achieve sufficient irrigation in the frontal sinus. Due to decreased backpressure in the nasal passage, increasing septectomy in Draf III did not significantly improve irrigation delivery. Squeeze bottles achieved significantly higher irrigation flow in the frontal sinus than syringes and pulsating devices. Large-volume irrigation devices provided better irrigation for the frontal sinus by entering or flushing the entire frontal sinus. The head position influenced the frontal sinus irrigation by altering the ostia position relative to fluid flow and vertical height of the frontal sinus during irrigation. While the vertex down head position was likely to enhance frontal sinus irrigation, the comfort of the head position and patient compliance should be considered.
CONCLUSIONS: Elements for optimization of frontal sinus irrigation are a minimum of a Draf IlA procedure for frontal sinus dissection, use of large-volume irrigation, and vertex down head positioning. Developing comfortable head positions with high frontal sinus irrigation efficiency would increase patient compliance and improve outcomes.
UNASSIGNED: NA.
摘要：
目的：额窦由于其相对于鼻孔和筛窦的位置，仍然是冲洗的挑战性部位。本研究旨在总结慢性鼻-鼻窦炎（CRS）患者鼻内镜手术（ESS）后有效冲洗额窦的必要因素。
方法：使用首选报告项目进行系统评价和荟萃分析（PRISMA）指南，在PubMed上进行了系统的文献综述，Scopus,和Cochrane数据库来确定评估CRS患者额窦冲洗效果的研究，尸体模型,或ESS后鼻窦腔的3D打印模型。
结果：在审查的最初206份摘要中，共收录18篇全文。发现ESS后额窦口开放的程度与额窦冲洗的功效有关。更广泛的额窦手术倾向于增加额窦渗透。DrafIIA程序被确定为在额窦实现充分冲洗的最低标准。由于鼻通道的背压降低,在DrafIII中增加隔膜切除术并不能显着改善冲洗分娩。挤压瓶在额窦的冲洗流量明显高于注射器和脉动装置。大容量冲洗装置通过进入或冲洗整个额窦，为额窦提供了更好的冲洗。头部位置通过在冲洗期间改变相对于流体流量和额窦的垂直高度的口位置来影响额窦冲洗。虽然顶点向下的头部位置可能会增强额窦冲洗，应考虑头部位置的舒适性和患者的依从性。
结论：优化额窦冲洗的要素是最低限度的DrafIlA额窦夹层手术，使用大容量灌溉，和顶点向下头部定位。开发具有高额窦冲洗效率的舒适头部位置将增加患者依从性并改善结果。
■NA。
方法：使用首选报告项目进行系统评价和荟萃分析（PRISMA）指南，在PubMed上进行了系统的文献综述，Scopus,和Cochrane数据库来确定评估CRS患者额窦冲洗效果的研究，尸体模型,或ESS后鼻窦腔的3D打印模型。
结果：在审查的最初206份摘要中，共收录18篇全文。发现ESS后额窦口开放的程度与额窦冲洗的功效有关。更广泛的额窦手术倾向于增加额窦渗透。DrafIIA程序被确定为在额窦实现充分冲洗的最低标准。由于鼻通道的背压降低,在DrafIII中增加隔膜切除术并不能显着改善冲洗分娩。挤压瓶在额窦的冲洗流量明显高于注射器和脉动装置。大容量冲洗装置通过进入或冲洗整个额窦，为额窦提供了更好的冲洗。头部位置通过在冲洗期间改变相对于流体流量和额窦的垂直高度的口位置来影响额窦冲洗。虽然顶点向下的头部位置可能会增强额窦冲洗，应考虑头部位置的舒适性和患者的依从性。
结论：优化额窦冲洗的要素是最低限度的DrafIlA额窦夹层手术，使用大容量灌溉，和顶点向下头部定位。开发具有高额窦冲洗效率的舒适头部位置将增加患者依从性并改善结果。
■NA。
