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摘要: 慢性鼻窦炎(CRS)是最常见的鼻部疾病之一，复杂的额窦引流通道(FSDP)是导致CRS发生的危险因素。由于额隐窝气房变异阻塞FSDP，使得鼻内镜下额窦手术难度增大，复发率较其他鼻窦手术更高。因此术前对患者进行精细薄层的CT扫描，充分评估额窦的解剖结构和引流途径，了解FSDP的气房变异对于精准开放额窦显得至关重要。本文报道1例巨大筛泡上额气房感染病例，术前充分阅片了解额隐窝的解剖结构，辨别各气房之间的空间关系，制定合适的手术方案，有利于术者在术中精准开放引流，避免术后复发。Abstract: Chronic sinusitis (CRS) is one of the most common nasal diseases, and FSDP is a risk factor for CRS. The variation of the frontal recess cell obstructs the frontal sinus drainage pathway, which makes the frontal sinus surgery more difficult and a higher recurrence rate than other sinus surgeries. Therefore, before surgery, a thin-slice CT scan is performed on the patient to fully evaluate the anatomical structure and drainage pathway of the frontal sinus, and to understand the variation of FSDP cell is crucial for accurate opening of the frontal sinus. In this paper, A case of large supra bulla frontal cell infection was summarized and analyzed. The anatomical structure of the frontal recess was fully understood by preoperative radiographs, the spatial relationship between the cells was identified, and the appropriate surgical plan was developed, which was beneficial for the surgeon to accurately open the frontal cortex during surgery and avoid postoperative recurrence.
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Key words:
- sieve bubble /
- frontal recess /
- endoscopic sinus surgery
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图 2 三维CT检查 左侧筛泡上巨大气房向额窦腔气化，几乎占据所有额窦腔，额窦腔狭小2a：冠状位；2b：水平位；2c：矢状位；图3 三维CT检查 左额窦自鼻丘气房及鼻丘上气房后内方引流3a：冠状位；3b：水平位；3c：矢状位；图4 三维CT检查 左侧筛前动脉位于筛泡上额气房后方4a：冠状位；4b：水平位；4c：矢状位；图5 三维CT 左侧筛后动脉位于前颅底后方检查5a：冠状位；5b：水平位；5c：矢状位。
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