上颌窦囊肿手术进路的选择  

Surgical approaches for maxillary sinus cyst

作　　者：郝建莹[1] 孔红[2] 朱冬冬[2] 孟粹达[2] 

机构地区：[1]吉林省吉林中西医结合医院耳鼻咽喉科,吉林吉林132012 [2]吉林大学中日联谊医院耳鼻咽喉头颈外科,吉林长春130033

出　　处：《中国耳鼻咽喉头颈外科》2009年第1期39-41,共3页Chinese Archives of Otolaryngology-Head and Neck Surgery

基　　金：吉林省发改委资助项目([2005]1564)

摘　　要：目的探讨鼻内镜下3种摘除上颌窦囊肿进路的选择。方法本组上颌窦囊肿共32例,术前均经鼻窦CT扫描和鼻内镜检查,明确鼻腔情况、囊肿的大小及位置。其中8例伴鼻窦炎鼻息肉者,经中鼻道自然口开放术进路行Messerkling术;19例单纯上颌窦囊肿患者,鼻内镜下经改良柯-陆进路行囊肿摘除术,另5例采用下鼻道开窗进路行囊肿摘除术。结果术后随访6个月～1年,鼻窦CT冠状位扫描或鼻内镜检查,19例经改良柯-陆进路者术后无复发;8例经中鼻道自然口开放术进路者,2例复发,1例术后窦口闭锁,中鼻甲与鼻腔外侧壁粘连;5例经下鼻道开窗进路者,1例复发,2例失访。结论3种术式各有优缺点,临床中应根据不同情况酌情选用。OBJECTIVE To investigate the surgical approaches for maxillary sinus cyst. METHODS A total of 32 patients with maxillary sinus cyst underwent operation for removal the cysts. Among them, 8 patients with maxillary sinus cyst and sinusitis were operated on through Messerklinger approach, 19 patients with maxillary cyst received modified CaldwellLuc operation under nasal endoscope and 5 patients received endoscopic removal of maxillary cyst through the maxillary sinus antrostomy at the inferior nasal meatus. RESULTS All the patients were followed up for 6 months to one year. There was no recurrence found in patients received modified CaldwelI-Luc operation. There were 2 patients recurred in 8 patients who were operated on through Messerklinger approach and one patient had closure of the maxillary sinus ostium and adhesion of nasal cavity. One patient recurred and 2 lost follow up in 5 patients who received endoscopic removal of maxillary cyst through the maxillary sinus antrostomy at the inferior nasal meatus. CONCLUSION The optimal surgical method for maxillary cyst is modified Caldwell-Luc operation under nasal endoscope. Messerklinger technique may suitable for patients with complicated sinusitis.

关 键 词：上颌窦 囊肿 内窥镜检查 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]