累及上颌窦牙源性囊肿经鼻内镜手术治疗及预后观察  

A clinical observation on the therapeutic effect and prognosis of cases with odontogenic cysts involving maxillary sinus treated by transnasal endoscopic surgery

作　　者：夏交[1] 田昊[1] 王伟伟[1] 张汝祥[1] 马有祥[1] XIA Jiao;TIAN Hao;WANG Weiwei;ZHANG Ruxiang;MA Youxiang(Department of Otorhinolaryngology-Head and Neck Surgery,Friendship Hospital of Capital Medical University,Beijing 100050,China)

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：《中国中西医结合耳鼻咽喉科杂志》2022年第5期344-351,共8页Chinese Journal of Otorhinolaryngology in Integrative Medicine

摘　　要：目的观察分析累及上颌窦的牙源性囊肿鼻内镜手术治疗效果及其预后。方法回顾性分析2016年1月~2021年9月在我科经鼻内镜手术治疗累及上颌窦的牙源性囊肿33例,总结其临床特点、手术进路选择和术后随访结果。结果本组累及上颌窦的牙源性囊肿患者中,包括根尖囊肿22例和含牙囊肿11例。最常见症状是单侧面颊肿痛或颌面部隆起。鼻窦CT或上颌骨锥形束计算机断层扫描成像(CBCT)是主要检查方法,多表现为累及上颌窦腔的薄壁骨性囊肿。全部患者均采用鼻内镜下鼻甲反转扩大下鼻道入路行囊肿造袋术,合并上颌窦口腔瘘者同期行瘘管修补术。术后随访3月左右,所有病例均未见囊肿复发,仅1例出现患侧上列牙麻木感。结论经鼻内镜囊肿造袋术处理累及上颌窦的牙源性囊肿,手术创伤小,囊肿复发率低。Objective To investigate the therapeutic effect and prognosis of cases with odontogenic cysts involving maxillary sinus treated by transnasal endoscopic surgery.Methods A retrospective study was carried out among 33 cases with odontogenic cysts involving maxillary sinus,treated in our department from January 2016 to September 2021,with their clinical characteristics,surgical approach selection and postoperatively following up results summarized systematically.Results Among these 33 cases,22 were seen with periapical cysts and 11 with dentigerous cysts.The commonest manifested clinical symptoms among them were swelling and painful feeling in cheek and maxillofacial protuberance developed only on one side.The commonly performed image examination techniques were sinus CT scanning or maxillary cone beam computerized tomography(CBCT),with very valuable diagnostic value by showing such image features as thin-walled bony cysts involving the maxillary sinus cavity among most cases.All these patients were treated by a cyst marsupialization under endoscope via a transnasal approach through the manner to extend the inferior meatus,by reversing the inferior turbinate.Once oroantral fistula was complicated,it was repaired simultaneously during the operation.As seen by the end of following up period lasted about 3 months,no recurrence of cyst was found among these cases,only 1 patient feeling upper teeth numbness on the operated side postoperatively.Conclusions Transnasal endoscopic cyst marsupialization can be effectively used to treat odontogenic cysts involving maxillary sinus,with such advantages as less invasive during the operation and lower lesion recurrence rates following surgery.

关 键 词：牙源性囊肿 上颌窦 内镜手术 造袋术 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]