目的：探讨鼻前庭囊肿的最佳治疗方法。方法:在鼻内镜下辅以鼻窦电动切割器，对32例患者行鼻前庭囊肿揭盖术。结果:32例均获治愈，无1例并发症，随访1年以上，均未见囊肿复发和并发症。结论:鼻内镜下辅以鼻窦电动切割器行鼻前庭囊肿揭盖术，具有手术精确、时间短、创伤小、愈合快等微创手术优点，值得推广。
【摘要】 目的 比较3种方法治疗鼻前庭囊肿的优缺点，探讨鼻前庭囊肿的最佳治疗方法。 方法 2002年1月-2008年6月收治鼻前庭囊肿患者84例，随机分为3组，分别采用微波、鼻前庭揭盖术和唇龈沟切口径路鼻前庭囊肿切除术治疗。 结果 84例患者均治愈。3组治疗时间和出血量比较均有统计学意义（Plt;0.05）。术后4例发生感染，分别为鼻前庭揭盖术组1例（3.57%），唇龈沟切口径路鼻前庭囊肿切除术组3例（10.71%）。随访1年，仅微波治疗组3例患者（10.71%）因囊肿壁残留复发，行鼻内镜下鼻前庭囊肿揭盖术后治愈。 结论 鼻内镜下鼻前庭囊肿；揭盖术具有精确、微创、手术时间短、并发症少、复发率低等优点。【Abstract】 Objective To identify the best treatment method for nasal vestibular cyst by comparing three kinds of operative methods. Methods Eighty-four patients with nasal vestibular cyst in this department were divided into three groups from January 2002 to June 2008. They were operated by microwave, uncover method under nasal endoscope and cyst cxcision by crevicular lip approach, respectively. Results All of the 84 patients were cured with 4 infected: one patient (3.57%) was operated by uncover method under nasal endoscope and three patients (10.71%) were operated by cyst excisionby crevicular lip approach. On the contrast of quality of blooding and operating time, there was significant difference among the three operative methods (Plt;0.05). Only three patients (10.71%) operated by microwave recurred after one year of follow-up caused by remained cyst, which were cured after reoperated by uncover method under nasal endoscope. Conclusion Uncover method under nasal endoscope is an effective operation for treating nasal vestibular cyst with such advantages as less trauma, precise operation, short operative time, and less recurrence.
Objective To explore short-term effectiveness of floating island laminectomy surgery in treating thoracic spinal stenosis and myelopathy caused by ossification of the ligamentum flavum. Methods A total of 31 patients with thoracic spinal stenosis and myelopathy caused by thoracic ossification of the ligamentum flavum between January 2019 and April 2022 were managed with floating island laminectomy surgery. The patients comprised 17 males and 14 females, aged between 36 and 78 years, with an average of 55.9 years. The duration of symptoms of spinal cord compression ranged from 3 to 62 months (mean, 27.2 months). The lesions affected T1-6 in 4 cases and T7-12 in 27 cases. The preoperative neurological function score from the modified Japanese Orthopaedic Association (mJOA) was 4.7±0.6. Surgical duration, intraoperative blood loss, and complications were recorded. The thoracic MRI was conducted to reassess the degree of spinal cord compression and decompression after operation. The mJOA scoring system was employed to evaluate the neurological function and calculate the recovery rate at 12 months after operation. Results The surgical duration ranged from 122 to 325 minutes, with an average of 204.5 minutes. The intraoperative blood loss ranged from 150 to 800 mL, averaging 404.84 mL. All incisions healed by first intention after operation. All patients were followed up 12-14 months, with an average of 12.5 months. The patients' symptoms, including lower limb weakness, gait disorders, and pain, significantly improved. The mJOA scores after operation significantly increased when compared with preoperative levels (P<0.05), gradually improving with time, with significant differences observed among 1, 3, and 6 months (P<0.05). The recovery rate at 12 months was 69.76%±11.38%, with 10 cases exhibiting excellent neurological function and 21 cases showing good. During the procedure, there were 3 cases of dural tear and 1 case of dural defect. Postoperatively, there were 2 cases of cerebrospinal fluid leakage. No aggravated nerve damage, recurrence of ligamentum flavum ossification, or postoperative thoracic deformity occurred. ConclusionThe floating island laminectomy surgery is safe for treating thoracic spinal stenosis and myelopathy caused by ossification of the ligamentum flavum, effectively preventing the exacerbation of neurological symptoms. Early improvement and recovery of neurological function are achieved.