下鼻甲反转扩大下鼻道入路处理上颌窦及毗邻结构病变  

Extended inferior meatal approach by reversing inferior turbinate for maxillary sinus and adjacent lesions

作　　者：夏交[1] 马有祥[1] 田昊[1] 张汝祥[1] 

机构地区：[1]首都医科大学附属北京友谊医院耳鼻咽喉头颈外科,北京100050

出　　处：《临床耳鼻咽喉头颈外科杂志》2016年第16期1271-1275,共5页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：首都医科大学基础临床基金(No:16JL71)

摘　　要：目的：探讨下鼻甲反转扩大下鼻道入路处理上颌窦及毗邻结构病变的可行性及手术疗效。方法：28例患者中,上颌骨囊肿9例（其中4例伴上颌窦口腔瘘）,牙源性上颌窦炎2例（其中1例伴口腔瘘）,上颌窦囊肿3例,上颌窦后鼻孔息肉2例,上颌窦内翻性乳头状瘤5例,上颌窦内翻性乳头状瘤伴中度分化鳞状细胞癌浸润1例,眶下壁骨折4例,上颌窦前壁骨折1例,颞下窝囊肿伴真菌性上颌窦炎1例。全部患者均在鼻内镜下经扩大下鼻道入路完成手术。结果：均无术中并发症,随访3～36个月未见复发。结论：下鼻甲反转扩大下鼻道入路可用于处理各种上颌窦腔、窦壁、翼腭窝和颞下窝病变,手术视野清楚,成功率高。Objective：The aim of this study is to explore the feasibility and results of surgical removal of maxillary sinus and adjacent lesions via extended inferior meatal approach by reversing inferior turbinate.Method：Among these 28 cases,there were 9 cases of maxillary cysts（4 of which with oroantral fistula）,2 cases of odontogenic maxillary sinusitis（1 of which with oroantral fistula）,3 cases of maxillary sinus cysts,2cases of antrochoanal polyps,5 cases of maxillary sinus inverted papilloma,1 case of maxillary sinus inverted papilloma with infiltrative squamous cell carcinoma（moderately differentiated）,4 cases of inferior orbital fracture,1 case of anterior maxillary sinus wall fracture,and 1case of infratemporal fossa cysts with fungal maxillary sinusitis.All operations were conducted via extended inferior meatal approach.Result：All patients did not have intraoperative complications,and were free of recurrence after the 3 to 36 months postoperative follow-up.Conclusion：The extended inferior meatal approach by reversing inferior turbinate can deal with all aspects of the maxillary sinus and retromaxillary lesions.This procedure has a clear vision and high successful rate.

关 键 词：内镜外科手术 手术入路 下鼻甲 上颌窦 翼腭窝 颞下窝 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]