奇美醫學中心3D定位導航微創手術加生物製劑 擺脫頑劣鼻竇炎
2022-10-13 記者 蘇旋/報導
鼻竇炎、慢性過敏性鼻炎、鼻中隔彎曲及下鼻甲肥厚等疾病，都可能造成嗅覺減退、鼻塞、鼻涕倒流，嚴重者甚至會有咽喉異物感、睡眠張口呼吸、顏面疼痛等症狀，長期下來甚至會影響心血管的健康。奇美醫學中心運用3D定位導航微創手術加生物製劑，讓病患擺脫頑劣鼻竇炎，恢復正常的生活品質。
奇美醫學中心耳鼻喉部主治醫師李京澤（圖/奇美醫院提供）
奇美醫學中心耳鼻喉部主治醫師李京澤表示，若經檢查診斷為慢性鼻竇炎，會先以內科治療為主，目前鼻竇炎手術以功能性內視鏡鼻竇微創手術為主流，手術主要經由天然鼻孔開口進入，並無額外的傷口，便能將鼻息肉移除，及打開被阻塞的鼻竇開口。由於鼻竇位置緊鄰顱底及眼球，因此若遇到病灶緊鄰這些部位，手術清除則會較為保守，治療效果便有限。
奇美醫學中心耳鼻喉部主治醫師李京澤於3D定位導航微創手術畫面（圖/奇美醫院提供）
如今，鼻竇3D立體定位導航系統可以於術中即時定位病灶，使手術治癒率大增，減少術後疼痛與出血等併發症。3D定位導航的原理是將病人術前電腦斷層影像上傳至導航系統，於系統中建立鼻竇的3D立體模型，透過光學或磁力校正定位後，便能在影像上即時反應出感應器械的所在位置，十分精確且安全。3D立體定位導航系統也已納入健保給付範圍，若符合健保適應症則不需自費，是慢性鼻竇炎病人的一大福音。
電腦斷層顯示48歲曾先生有慢性鼻竇炎合併鼻息肉復發情形（圖/奇美醫院提供）
48歲曾先生，有氣喘病史，因慢性鼻竇炎合併鼻息肉反覆發作，過去已接受鼻竇炎手術多達七次。且左側鼻子的嗅覺完全喪失，無味的日子已有兩年之久。今年7月，曾先生因慢性鼻竇炎再次發作，至奇美醫學中心耳鼻喉部門診求診，經檢查發現曾先生鼻黏膜息肉增生化膿，電腦斷層顯示雙側鼻息肉復發，診斷為「第二型發炎反應導致的慢性鼻竇炎合併鼻息肉」。經討論後即安排鼻竇3D立體定位導航微創手術，術後並給予生物製劑「杜避炎」治療。如今可聞到味道，已是難得，生活品質也因此而提升不少。
奇美醫學中心耳鼻喉部主治醫師李京澤表示：3D定位導航微創手術加生物製劑，擺脫頑劣鼻竇炎（圖/奇美醫院提供）
隨著鼻竇炎致病機轉的研究，目前已發現「第二型發炎反應」和慢性鼻竇炎合併鼻息肉有關，而第二型發炎反應也是氣喘、異位性皮膚炎、慢性自發性蕁麻疹的成因之一。目前已有國際期刊指出，生物製劑「杜避炎」亦能快速且持續地改善此類病人的嗅覺，對於鼻竇炎治療，更是邁向精準醫療的一大步。
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