中鼻道联合泪前隐窝入路治疗上颌窦良性病变  

Treatment of maxillary sinus disease through windowing middle meatus maxillary sinus and the frontal recess of tears

作　　者：周虎军[1] 谢金[1] 

机构地区：[1]安徽医科大学附属合肥医院耳鼻咽喉头颈外科,合肥230011

出　　处：《安徽医学》2012年第12期1626-1629,共4页Anhui Medical Journal

摘　　要：目的探讨鼻内镜下经中鼻道上颌窦开窗联合泪前隐窝入路,治疗上颌窦良性病变的临床疗效。方法鼻内镜下经中鼻道上颌窦开窗联合泪前隐窝入路,治疗22例上颌窦良性病变患者,其中复发性上颌窦炎伴息肉3例、真菌性上颌窦炎5例、上颌窦囊肿12例、出血坏死性息肉2例。泪前隐窝入路解剖或不解剖鼻泪管,根据病变情况决定是否去除上颌窦前内下壁骨质,所有患者均行下鼻道开窗。结果随访6个月～1年,复发性慢性上颌窦炎伴息肉病例,术腔局部黏膜囊性泡状隆起;真菌性上颌窦炎窦腔黏膜水肿,3次换药及鼻腔冲洗,创面逐步上皮化。所有患者切口完全愈合,无膜性鼻泪管损伤或面颊部麻木发生,下鼻甲形态正常无坏死,下鼻道开窗口引流通畅。结论鼻内镜下经中鼻道上颌窦开窗联合泪前隐窝入路治疗上颌窦良性病变,视野宽阔,清除病灶彻底,术后换药视窗清晰。该方法为治疗上颌窦良性病变提供了创伤小、疗效佳的新途径。Objective To study the clinical efficacy of windowing middle meatus maxillary sinus of nasal endoscope, associated with frontal recess of tears approach on the treatment of maxillary sinus disease. Methods A total of 22 patients, under the guidance of endoscope, were performed with windowing of middle meatus maxillary sinus associated with frontal recess of tears approach in the treatment of maxillary sinus disease. Of them, there were 3 cases of recurrent maxillary sinusitis associated with polyps, five cases of fungal maxillary sinusitis, twelve cases of maxillary sinus cyst, and 2 cases of hemorrhagic and necrotic polyps. All patients also underwent windowing of inferior nasal meatus, and at the same time, whether to remove maxillary sinus before the next wall bathe was decided according to the lesions, Resuits Followed up of 6 months to 1 year, in cases of recurrent chronic maxillary sinusitis with polyps , the local mucosal of the surgical cavity showed cystic bubbly uplift; in cases of fungal maxillary sinusitis sinus mucosal edema, after given dressing and nasal irrigation, there was gradual epithelialization of the wound mucosa of the maxillary sinus cavity. No case reported membranous nasolacrimal duct injury as well as cheek numbness and other complications. All incisions were healed properly, inferior turbinate was morphologically normal, there was no local necrosis, and the windowing of inferior nasal meatus showed unobstructed drainage. Conclusion The approach of windowing middle meatus maxillary sinus associated with frontal recess of tears in the treatment of maxillary sinus disease in nasal endoscope has wide field and no dead ends. Moreover, the lesions can be cleared completely. The method provides a clear window for the follow - up treatment of the maxillary sinus cavity and dressing in nasal endoscopic treatment. With little trauma and satisfactory clinical outcome, it provides a new way of treating benign changes in maxillary sinus.

关 键 词：中鼻道 泪前隐窝 上颌窦疾病 鼻内镜 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]