多学科合作模式在根尖周炎所致鼻腔瘘道的临床应用研究  

Clinical application of multidisciplinary treatment model in nasal fistular caused by periapical periodontitis

作　　者：秦峰 孙艺渊[1] 樊林峰 王珮华[1] 顾申生 QIN Feng;SUN Yiyuan;FAN Linfeng;WANG Peihua;GU Shensheng(Department of Endodontics,Shanghai Ninth People's Hospital,College of Stomatology,Shanghai Jiao Tong University,National Center for Stomatology,National Clinical Research Center for Oral Diseases,Shanghai Key Laboratory of Stomatology,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院牙体牙髓科,上海交通大学口腔医学院,国家口腔医学中心,国家口腔疾病临床医学研究中心,上海市口腔医学重点实验室,上海交通大学医学院附属第九人民医院耳鼻咽喉头颈外科,上海交通大学医学院耳科学研究所,上海市耳鼻疾病转化医学重点实验室,上海交通大学医学院附属第九人民医院放射科,上海200011

出　　处：《中国中西医结合耳鼻咽喉科杂志》2022年第5期352-356,共5页Chinese Journal of Otorhinolaryngology in Integrative Medicine

摘　　要：目的探讨多学科合作模式在根尖周炎所致鼻腔瘘道治疗中的临床应用价值。方法2020年1月~2020年12月收治的2例根尖周炎合并鼻腔瘘道患者,采用牙体牙髓科、耳鼻喉科、放射科多学科合作模式,共同分析术前根尖X线片及锥状束计算机断层扫描(CBCT)影像治疗,评估病灶牙及其邻近上颌骨相关情况,制定针对性手术方案,然后在显微镜下行显微根尖手术,同时实施鼻内镜下鼻腔瘘道切除术;术后随访6个月。结果2例根尖周炎合并鼻腔瘘道患者,鼻部瘘道及根尖周炎均一期愈合,未见病变复发。结论在根尖周炎合并鼻腔瘘道患者的诊疗过程中,多学科合作模式能够达到早期诊疗目的,疾病预后良好,具有临床实用价值。Objective To explore the clinical value of multidisciplinary cooperation,or multidisciplinary treatment(MDT),model in the treatment of nasal fistula caused by periapical periodontitis.Methods Two patients with periapical periodontitis complicated with nasal fistula were recruited from January 2020 to December 2020.Before operation,two patients underwent apical X-ray and cone beam computerized tomography(CBCT)to carefully evaluate the status of focus teeth and relating maxillary bone for surgical plan making by a cooperative way among doctors from Departments of Endodontics,Otolaryngology and Radiology.Then,microsurgical apical procedure was performed under a microscope,followed by nasal fistula resection under nasal endoscope.All these two cases were followed up for 6 months postoperatively.Results Two cases were cured with their periapical periodontitis and complicated nasal fistula healed completely at phaseⅠ,with no lesion recurred as evaluated by the end of following up period.Conclusions Clinical application of MDT model can achieve the purpose of early diagnosis,early treatment and better prognosis in the diagnosis and treatment of periapical periodontitis complicated with nasal fistula.It is worthful to be promoted to a much wider use in clinical practice.

关 键 词：多学科治疗 临床应用 根尖周炎 牙源性鼻瘘 

分 类 号：R781.341[医药卫生—口腔医学]