Endoscopic transnasal sinus opening

The frontal sinus opening is located at the bottom of the frontal sinus, which is funnel-shaped and moves down into a nasal forehead, opening in the frontal crypt. Its funnel-shaped narrowest part is called the frontal gorge. The posterior part of the frontal funnel has a anterior ethmoid artery and a sieving bubble. The front boundary is a nasal cavity, the outer side is the sacral wall, and the inner side is the middle turbinate. When the upper end of the uncinate process is attached to the base of the skull or the middle turbinate, the frontal sinus is drained to the middle nasal passage through the sieve funnel; when the upper end of the uncinate process is attached to the cardboard, the frontal sinus is directly drained to the middle nasal passage. Treatment of diseases: chronic frontal sinusitis Indication 1. Chronic frontal sinusitis. 2. Frontal sinus mucus cyst. Preoperative preparation 1. Identify diagnostic and surgical indications and eliminate contraindications. 2. Read the film carefully to determine the surgical plan. 3. Conventional preoperative examination (blood routine, platelet, liver and kidney function, coagulation function, electrocardiogram and chest radiograph). 4. Pre-operative signature. 5. Use antibiotics 1 to 3 days before surgery. 6. Cut nose hair 1d before surgery. 7. Intramuscular hemostatic drugs 30 min before surgery. 8. General anesthesia according to general anesthesia routine. Surgical procedure 1. Excision of the uncinate body, opening of the ethmoid sinus 2. Excision of the uncinate head under a 30° or 70° microscope, using a 45° or 90° sinus occipital forceps to bite the anterior upper part of the uncinate to the chopped cardboard and near the skull base. 3. If the nasal cavity gasification is extensive, the nasal cavity can be removed first, and the crypt is fully revealed. First identify the sinus sinus and find the anterior ethmoid artery. There is a small crypt in front of the anterior ethmoid artery (which is easily mistaken for the frontal sinus opening), and the frontal sinus opening is in front of this crypt. When the frontal sinus opening is not easy to recognize, you can find the anterior ethmoid artery and look forward to the frontal sinus opening. 4. Sometimes, depending on the discharge from the frontal sinus opening, the position of the frontal sinus opening can be determined. Carefully clean the diseased tissue around the frontal sinus opening and fully expose the frontal sinus opening. It is usually not necessary to enlarge the sinus opening. 5. Exploit the nasal forehead with a curved aspirator head and insert a bone piece around the opening of the nasal foramen to enlarge the opening. Try to keep the periorbital mucosa of the nasal forehead. 6. If the 4mm curved suction head can be easily inserted into the nasal front tube, the general recovery is good. If the nasal frontal tube is narrow, the modified Lothrop surgery can be performed at the endoscope as appropriate.

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