骨修复材料在牙源性上颌窦炎口窦沟通修复中的运用  

Use of bone repair materials in Oro sinus communication repair of odontogenic maxillary sinusitis

作　　者：陈东[1] 汪涛[1] 徐洲 王钟颖[1] CHEN Dong;WANG Tao;XU Zhou;WANG Zhongying(Department of Otohinolaryngology Head and Neck Surgery,Shanghai Ninth people’s Hospital,Shanghai JiaoTong University School of Medicine/Ear Institute,Shanghai JiaoTong University School of Medicine/Shanghai Key Laboratory of Translational Medicine on Ear and Nose diseases,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,200011

出　　处：《中国中西医结合耳鼻咽喉科杂志》2022年第5期371-373,382,共4页Chinese Journal of Otorhinolaryngology in Integrative Medicine

摘　　要：目的探讨骨修复材料在牙源性上颌窦炎口窦沟通在修复中的运用价值。方法对2020年1~12月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收治的牙源性上颌窦炎,拔除残牙后口窦瘘,运用骨修复材料修复的4例患者行回顾性分析。男性2例,女性2例;年龄31~64岁;2例与第一磨牙有关,1例第二磨牙,1例第三磨牙。4例患者症状除牙痛外,均有鼻腔异味多日,术前口腔科就诊,明确残牙已无保留可能,需拔牙治疗;术前CT检查,均提示有残牙牙根突入窦腔,上颌窦内低密度影,2例人术前鼻内镜检查,见上颌窦口有白色脓液溢出。手术行鼻内镜下上颌窦窦口开放扩大术;拔出残牙,清除炎性肉芽,探明已出现口窦沟通,用生理盐水冲洗干净后,植入骨修复材料,用颊黏膜推进瓣和腭黏骨膜旋转瓣覆盖缝合。术后使用减充血剂,抗生素;口腔漱口,软质饮食。结果4例患者均一期愈合,未出现口窦瘘的发生。结论骨修复材料在口窦沟通的治疗中,作为修复用材料,安全有效,为今后行种植牙提供了基础。Objective To investigate the use of bone repair materials in odontogenic maxillary sinusitis orodental communication in repair.Methods patients who underwent odontogenic maxillary sinusitis,fistula of the oral sinus after extraction of residual teeth,and repair using bone repair materials between January 2020 and December 2020 at the Department of Otolaryngology,head and neck surgery,Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of medicine were retrospectively reviewed.2 male and 2 females;age,31-64 years;2 patients were associated with first molars,1 patient with second molars,and 1 patient with third molars.Four patients had symptoms other than dental pain,all had a peculiar nasal smell on many days,preoperative dental visits,and it was clear that the residual teeth had not been retained and required tooth extraction.The preoperative CT examination,all of which suggested that there were residual tooth roots protruding into the sinus cavity,low-density shadow in the maxillary sinus.Two patients had preoperative nasoendoscopy and were seen to have white pus spillage from the maxillary ostia.Surgery performed nasoendoscopic maxillary sinus ostium development expansion;the residual teeth were extracted,the inflammatory granulation was cleared,and the sinus communication was seen by explorations;After being rinsed with normal saline solution,bone repair materials were implanted.Sutures were covered with a buccal mucosa advancement flap and a palatal mucoperiosteal rotation flap.Use of decongestants,antibiotics postoperatively;mouth rinse and soft diet.Results 4 patients healed homogeneously,and no oroantral fistula occurred.Conclusions Bone repair materials in the treatment of Oro sinus communication,as a material for repair,are safe and effective,and provide a basis for the future use of dental implants.

关 键 词：牙源性上颌窦炎 口窦瘘 

分 类 号：R765.42[医药卫生—耳鼻咽喉科]