The Treatment Of Isolated Sphenoid Sinus Disease By Nasal Endoscope In Sphenoid Ostium Approach With Middle Turbinate Reserved

Objective: To observe and analyze the feasibility and clinical effect of endoscopic natural oral approach for the treatment of isolated sphenoid sinus disease.Method: 60 patients who were diagnosed with isolated sphenoid sinus disease confirmed by preoperative CT examination were randomly divided into two groups,sphenoidotomy by sphenoid ostium approach with middle turbinate preservation was performed in 30 patients in the experimental group,and 30 patients in the control group underwent Wigand sphenoid sinus surgery.Regular follow-up all patients for more than 6 months after surgery.Postoperative curative effect evaluation methods refer to the standards established by chronic nasal sinusitis diagnosis and treatment guidelines in 2012 in Kunming,and divide the results into three levels: complete controlled,portion controled and uncontrolled.Result: 30 cases in the experimental group were successfully operated on by this method,and no serious complications occurred during and after operation.Combined with intraoperative observation and postoperative pathological report,17 patients were diagnosed with fungal sphenoid sinusitis patients,11 patients were diagnosed with chronic sphenoid sinusitis patients,2patients were diagnosed with sphenoid sinus cyst patients,29 patients were in complete control,1 patient was in portion controlled,effective rate was100.0%.In the control group,13 patients were diagnosed with fungal sphenoid sinusitis patients,12 patients were diagnosed with chronic sphenoid sinusitis patients,5 patients were diagnosed with sphenoid sinus cyst patients,25 patients were in complete control,3patient was in portion controlled,2 cases relapsed and were recorded as uncontrolled,effective rate was 93.3%.There was no significant difference in the efficiency between the two groups(P>0.05).Conclution: Sphenoidotomy in sphenoid ostium approach with middle turbinate preservation is feasibility to treat isolated sphenoid sinus disease and is the preferred surgical method for the treatment of isolated sphenoid sinus diseases.The complete preservation of the normal structure and function of the middle turbinate is in line with the concept of healing and minimally invasive treatment.The use of plasma knife or high frequency electrotome is helpful to reduce the operation bleeding and trauma.