Clinical analysis of the treatment of maxillary odontogenic cyst by nasal endoscope fenestration through nasal base
-
摘要: 目的 探讨鼻内镜下经鼻底开窗治疗上颌骨牙源性囊肿的手术进路及方法的可行性及临床效果。方法 回顾性分析鼻内镜下经鼻底开窗治疗23例上颌骨牙源性囊肿的临床资料。所有患者术前均行鼻内镜、CT检查。手术先经鼻底开窗切除囊肿顶壁黏膜，减压并清除囊液，修整及扩大鼻底骨性开口至囊肿边缘，再观察术中情况及术后疗效。结果 全部患者均能在鼻内镜直视下良好暴露，最大限度地切除囊肿顶壁使囊腔与鼻底沟通，术后无鼻泪管损伤、无鼻甲萎缩、坏死及面部麻木等并发症。随访6~12个月，所有患者术后临床症状逐渐消失，下鼻甲形态良好，囊腔引流通畅，囊壁上皮化，未见囊肿复发。结论 鼻内镜下经鼻底开窗治疗上颌骨牙源性囊肿，手术操作方便、创伤小、并发症少且疗效满意，值得临床推广。Abstract: Objective To investigate the feasibility and clinical effect of the surgical approach and method of transnasal fenestration under nasal endoscope for the treatment of maxillary odontogenic cyst.Methods The clinical data of 23 cases with maxillary odontogenic cysts treated by nasal endoscopy through nasal fenestration were retrospectively analyzed. All cases underwent nasal endoscopy and CT examination before the operation. The mucosal membrane of the parietal wall of the cyst was excised through fenestration of the nasal base. The cyst fluid was removed by decompression, and the bony opening of the nasal base was trimmed and enlarged to the edge of the cyst. The intraoperative and postoperative effects were observed.Results All cases were well exposed under the direct vision of nasal endoscope. The top wall of the cyst was removed to maximize the communication between the cyst cavity and the nasal floor. There were no complications such as nasolacrimal duct injury, turbinate atrophy, necrosis, and facial numbness. All patients were followed up for 6-12 months, and the clinical symptoms gradually disappeared after surgery. The inferior turbinate was in good shape, the cyst cavity was smooth, the cyst wall was determined, and no cyst recurrence was observed.Conclusion The treatment of odontogenic cyst of maxilla under nasal endoscope through nasal fenestration is convenient. It has less trauma, fewer complications and a satisfactory curative effect, which is worthy of clinical promotion.
-
Key words:
- maxillary odontogenic cyst /
- nasal endoscopy /
- transnasal fenestration
-
-
[1] Kouhsoltani M, Mesgarzadeh AH, Moradzadeh Khiavi M. Mandibular Fracture Associated with a Dentigerous Cyst: Report of a Case and Literature Review[J]. J Dent Res Dent Clin Dent Prospects, 2015, 9(3): 193-198. doi: 10.15171/joddd.2015.035
[2] Sivapathasundharam B, Biswas PG, Preethi S. The World Health Organization classification of odontogenic and maxillofacial bone tumors: An appraisal[J]. J Oral Maxillofac Pathol, 2019, 23(2): 178-186. doi: 10.4103/jomfp.JOMFP_211_19
[3] 孙虹, 张罗. 耳鼻咽喉头颈外科学[M]. 北京: 人民卫生出版社, 2019: 243-244.
[4] Soluk-Tekkesin M, Wright JM. The World Health Organization Classification of Odontogenic Lesions: A Summary of the Changes of the 2017(4th)Edition[J]. Turk Patoloji Derg, 2018: 34(1).
[5] 杨胜华, 吴英哲. CBCT对颌骨囊肿术前评估应用价值[J]. 医学影像学杂志, 2022, 32(11): 1995-1997.
[6] 邱蔚六. 口腔颌面外科学[M]. 6版. 北京: 人民卫生出版社, 2008: 257-259.
[7] Deboni MC, Brozoski MA, Traina AA, et al. Surgical management of dentigerous cyst and keratocystic odontogenic tumor in children: a conservative approach and 7-year follow-up[J]. J Appl Oral Sci, 2012, 20(2): 282-285. doi: 10.1590/S1678-77572012000200025
[8] Ettl T, Gosau M, Sader R, Reichert TE. Jaw cysts-filling or no filling after enucleation? A review[J]. J Craniomaxillofac Surg, 2012, 40(6): 485-493. doi: 10.1016/j.jcms.2011.07.023
[9] 陈爱国. 数字化技术在下颌骨囊性肿物开窗减压术治疗中的应用[J]. 中外医疗, 2021, 40(36): 89-92. https://www.cnki.com.cn/Article/CJFDTOTAL-HZZZ202136023.htm
[10] Sun KT, Chen MY, Chiang HH, et al. Treatment of large jaw bone cysts in children[J]. J Dent Child(Chic), 2009, 76(3): 217-222.
[11] 洪育明, 许志辉, 吴文源, 等. 开窗减压术在颌骨囊性病变治疗中的应用[J]. 临床耳鼻咽喉头颈外科杂志, 2013, 27(16): 908-910. https://www.cnki.com.cn/Article/CJFDTOTAL-LCEH201316017.htm
[12] 金岚, 赵文妍, 阮妍, 等. 开窗减压术治疗颌骨囊肿的临床价值[J]. 中华全科医学, 2021, 19(11): 1851-1854. https://www.cnki.com.cn/Article/CJFDTOTAL-SYQY202111015.htm
[13] 连冈. 鼻内镜下单纯鼻底开窗术治疗上颌骨囊肿的临床观察[J]. 临床耳鼻咽喉头颈外科杂志, 2011, 25(11): 489-490, 494. https://www.cnki.com.cn/Article/CJFDTOTAL-LCEH201111006.htm
[14] 冀永进, 李青峰, 韩剑星, 等. 鼻内镜下上颌骨囊肿开放术[J]. 临床耳鼻咽喉头颈外科志, 2012, 26(17): 798-800. https://www.cnki.com.cn/Article/CJFDTOTAL-LCEH201217013.htm
[15] 吴家森, 殷海, 何引, 等. 鼻内镜下泪前隐窝入路治疗上颌窦良性病变的临床研究[J]. 临床耳鼻咽喉头颈外科杂志, 2016, 30(11): 902-906. https://www.cnki.com.cn/Article/CJFDTOTAL-LCEH201611016.htm
-
下载:
图(3)
计量
- 文章访问数: 847
- PDF下载数: 125
- 施引文献: 0