改良泪前隐窝入路处理上颌窦良性病变的临床研究

王明婕; 周兵; 李云川; 崔顺九; 黄谦

doi:10.13201/j.issn.1001-1781.2018.24.001

改良泪前隐窝入路处理上颌窦良性病变的临床研究

- 首都医科大学附属北京同仁医院耳鼻咽喉头颈外科耳鼻咽喉头颈科学教育部重点实验室(首都医科大学)(北京, 100730)

详细信息

通讯作者: 周兵, E-mail:entzhou@263.net

中图分类号: R765.4

收稿日期: 2018-10-24

Clinical research on surgical treatment of benign lesions in maxillary sinus by modified prelacrimal duct recess approach

- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, and Key Laboratory of Otolaryngology Head and Neck Surgery(Capital Medical University), Ministry of Education, Beijing, 100730, China

More Information

Corresponding author: ZHOU Bing, E-mail: entzhou@263.net

Received Date: 24 October 2018

摘要

摘要: 目的: 探讨改良泪前隐窝入路处理上颌窦病变的临床应用效果以及手术方法和适应证。方法: 21例上颌窦良性病变患者均行鼻科常规术前检查及鼻窦影像学检查。患者均采用鼻内镜下改良泪前隐窝入路上颌窦手术,该术式采用经典泪前隐窝入路切口并向鼻底延长,保留下鼻甲骨及骨性鼻泪管,进入上颌窦腔去除病变后对位缝合切口。术后给予患者常规药物治疗,并规范内镜随访3~16个月,平均11.3个月。结果: 21例患者分别诊断为上颌窦囊肿9例,复发上颌窦后鼻孔息肉6例,上颌窦出血坏死性息肉5例,上颌窦根尖囊肿1例。术中探查囊肿、后鼻孔息肉及出血坏死性息肉的根蒂部位为上颌窦前下壁齿槽隐窝、前下泪前隐窝或上颌窦前壁。所有患者术后恢复良好,上颌窦功能正常,病变均无复发,无鼻周局部麻木、鼻翼塌陷、溢泪等并发症。结论: 改良泪前隐窝入路上颌窦手术通过改良切口、保留下鼻甲骨及骨性鼻泪管,可减小损伤,避免并发症,对于处理上颌窦前壁、前内下壁附着的良性病变有巨大优势,并可最大限度保留鼻腔、上颌窦的生理功能,是值得推广的手术技术。
- 内镜外科手术 /
- 改良泪前隐窝入路 /
- 上颌窦 /
- 良性病变
Abstract: Objective: To explore the clinical effects, surgical procedure and indications of surgical treatment for benign lesions in maxillary sinus through modified prelacrimal duct recess approach. Method: All 21 patients in this study who diagnosed with benign lesions in maxillary sinus, received routine preoperational exam and underwent endoscopic maxillary sinus surgery through modified prelacrimal duct recess approach. Postoperatively patients received routine medical treatment, and regular follow-up for average 11.3 months(from 3 months to 16 months). Result: Among 21 patients, there were 9 cases diagnosed with maxillary sinus cyst, 6 cases diagnosed with maxillary sinus choanal polyps, and 5 cases diagnosed with maxillary sinus hemorrhagic and necrotic polyps, 1 case of maxillary sinus root cyst. During the operation, the roots of maxillary sinus cyst or polyps were found in anterior or inferior wall of maxillary sinus. All patients recovered very well without recurrence.Conclusion: Modified prelacrimal duct recess approach appears to be a safe and effective method to resect benign lesions in the maxillary sinus, especially when lesions involved in anterior and inferior wall of the maxillary sinus.
- endoscopic surgical procedures /
- modified prelacrimal duct recess approach /
- maxillary sinus /
- benign lesions

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