%0 English Abstract
%T [DrafⅢ approach to unilateral frontal sinus for contralateral drainage].
%A Jiang X
%A Zhao K
%A Zhang H
%A Xue K
%A Liu Q
%A Gu Y
%A Zheng S
%A Sun X
%A Yu H
%J Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi
%V 38
%N 8
%D 2024 Aug
%M 39118512
暂无%R 10.13201/j.issn.2096-7993.2024.08.010
%X Objective:Anatomical variation or scar atresia of the drainage channel of the frontal sinus on the affected side, and opening the frontal sinus through the drainage channel of the frontal sinus on the affected side may lead to surgical failure. The purpose of this study is to explore a modified Draf Ⅲ operation to complete the drainage of the affected frontal sinus by removing the floor wall and septum of the frontal sinus and connecting the bilateral frontal sinus through the healthy side of the frontal sinus. Methods:Through the anatomical study of 2 skull bone specimens and 2 fresh frozen specimens, the surgical landmark and surgical approach were explored. Four patients with frontal sinus atresia and frontal sinusitis after DrafⅡb surgery in Eye & ENT Hospital of Fudan University were retrospectively analyzed. Descriptive method was used to analyze the data. Results:The bottom wall of bilateral frontal sinus was removed, and the bilateral frontal sinus was enlarged above the nasal septum to form a large common cavity. The uncinate process and ethmoid bubble were retained, and the midline drainage of the affected frontal sinus in the healthy side of the nasal cavity was completed. From August 2022 to April 2023, 4 patients with frontal sinus atresia and frontal sinusitis after DrafⅡb surgery for unilateral frontal sinus papilloma in Eye & ENT Hospital of Fudan University were treated with surgery. The headache symptoms disappeared after surgery, and the drainage of frontal sinus was spacious, the mucosa healed well and the drainage was unobstructed under endoscopy. There were no other postoperative complications. Conclusion:DrafⅢ approach to unilateral frontal sinus for contralateral drainage can drain the affected frontal sinus adequately. The essence of this operation is to drain the bilateral frontal sinus in the unilateral nasal cavity, and this operation has short path, less trauma, and a broader prospect, which is suitable for promotion.<BR>目的：患侧额窦的引流通道解剖变异或瘢痕闭锁，经患侧额窦引流通道开放额窦，可能会导致手术失败。本研究拟探索一种借健侧额窦和额隐窝为通路，磨除额窦底壁及额窦间隔，连通双侧额窦的改良DrafⅢ手术术式，完成患侧额窦的引流。 方法：通过对2个头颅骨性标本和2个新鲜冷冻标本的解剖研究，探索手术相关标志及手术路径。回顾性分析4例采用此术式进行治疗的患者。记录患者的相关临床资料，探讨该术式的技术细节和优缺点。 结果：通过2例头颅解剖研究，确认手术路径，借健侧额窦和额隐窝为通路，磨除双侧额窦底壁和额窦间隔，将双侧额窦在鼻中隔上方扩大成为一个大的共同腔，完成患侧额窦在健侧鼻腔的中线引流。4例患者因单侧额窦乳头状瘤行DrafⅡb手术，术后发生额窦闭锁、额窦炎，遂采用DrafⅢ借道引流术进行治疗。术后患者头痛症状消失，内镜下检查额窦引流口宽敞、黏膜愈合良好、引流通畅，无其他术后并发症。 结论：单侧额窦入路DrafⅢ借道引流术能充分引流患侧额窦。该术式创伤小，成功率高，有临床应用价值，适合单侧DrafⅡb手术失败的患者。.