经鼻内镜泪前隐窝进路上颌窦病变切除疗效分析  

Analysis of the efficacy of endoscopic resection of maxillary sinus lesions by prelacrimal recess approach

作　　者：季俊峰[1] 陈伟[1] 程友[1] 焦红叶 江满杰[1] 张勇[1] 许莉[1] JI Jun-feng;CHEN Wei;CHENG You;JIAO Hong-ye;JIANG Man-jie;ZHANG Yong;XU Li(Department of Otolaryngology Head and Neck Surgery,General Hospital of Eastern Theater Command,PLA,Nanjing 210002,Jiangsu,China)

机构地区：[1]东部战区总医院(原南京军区南京总医院)耳鼻咽喉头颈外科,南京210002

出　　处：《东南国防医药》2020年第6期608-611,共4页Military Medical Journal of Southeast China

摘　　要：目的探索经鼻内镜泪前隐窝进路上颌窦病变切除的手术方法、疗效及注意事项。方法回顾性分析自2014年l月到2018年2月东部战区总医院耳鼻咽喉头颈外科住院行经鼻内镜泪前隐窝进路上颌窦病变切除手术的23例患者临床资料,包括一般情况、术中所见、术后症状、内镜检查结果及术后并发症情况。结果23例经鼻内镜泪前隐窝进路上颌窦病变切除手术中,上颌窦内翻性乳头状瘤19例,Krouse分期均为T3期;上颌窦出血坏死性息肉4例。术后随访8~36个月,中位数随访时间l6个月,无严重并发症发生,无溢泪,无复发病例。术后症状均明显改善或消失。结论经鼻内镜泪前隐窝进路上颌窦手术暴露良好、无明显死角,病变清除易彻底,鼻泪管及鼻腔结构和功能保留良好。Objective To explore the surgical method,efficacy and details for the resection of maxillary sinus lesions by prelacrimal recess approach.Methods Clinical data of patients who underwent resection of maxillary sinus lesions by prelacrimal recess approach were retrospectively collected from from January 2014 to February 2018.General conditions,intraoperative observations,postoperative symptoms,endoscopic results and postoperative complications were recorded.Results A total of 23 cases of maxillary sinus lesions were removed by prelacrimal recess approach.All 19 cases of inverted papilloma of maxillary sinus matched T3 stage according to Krouse classification.4 cases of infarcted angiomatous nasal polyps were confirmed.The patients were followed up for 8 to 36 months after the operation,with a median follow-up time of l6 months.There were no serious complications,no epiphora,and no recurrent cases so far.Postoperative symptoms were significantly improved or disappeared.Conclusion Endoscopic prelacrimal recess approach has a good effect on maxillary sinus lesions.It has clear explosion,no dead angle,complete removal of lesions,good retention of nasolacrimal duct and nasal cavity structure and function was preserved well.

关 键 词：鼻内镜 泪前隐窝 上颌窦 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]