鼻内镜辅助治疗上颌骨囊肿34例临床分析  

CLINICAL ANALYSIS OF NASAL ENDOSCOPE-ASSISTED RESECTION IN 34 PATIENTS WITH MAXILLARY CYSTS

作　　者：赵桐 王琳 蒲珊珊 庞文会 郑莹 何海燕 鞠建宝[1] ZHAO Tong;WANG Lin;PU Shanshan;PANG Wenhui;ZHENG Ying;HE Haiyan;JU Jianbao(Department of Otolaryngo-logy,Head and Neck Surgery,The Affiliated Hospital of Qingdao University,Qingdao 266003,China)

机构地区：[1]青岛大学附属医院耳鼻咽喉头颈外科,山东青岛266003 [2]青岛市中心医院口腔科 [3]青岛西海岸新区人民医院 [4]青岛市中心医院

出　　处：《精准医学杂志》2023年第2期169-171,175,共4页Journal of Precision Medicine

基　　金：山东省自然科学基金面上项目(ZR2013HM024)。

摘　　要：目的探讨鼻内镜辅助切除上颌骨囊肿的手术方法、临床效果及影响上颌骨囊肿临床症状的相关因素。方法收集2018年5月-2022年5月我科收治的34例上颌骨囊肿患者的临床资料,分析鼻内镜辅助治疗上颌骨囊肿手术方法的选择情况及治疗的效果,同时收集患者术前和术后不同时间鼻面部不适程度视觉模拟评分(VAS),分析其影响因素。结果6例患者行经鼻内镜鼻底开窗入路手术,2例患者行经鼻内镜上颌窦自然窦口入路手术,1例患者行经鼻内镜下鼻道开窗入路手术,25例患者行经鼻内镜上颌窦自然窦口入路联合泪前隐窝入路手术。术后随访5~24个月,术腔黏膜上皮化良好,症状明显缓解,囊腔引流通畅,病例无复发。上颌窦组患者术前VAS评分明显高于鼻底组(t=2.242,P<0.05);牙源性上颌骨囊肿组患者术前VAS评分明显高于非牙源性上颌骨囊肿组(t=2.329,P<0.05)。结论鼻内镜下辅助治疗上颌骨囊肿,可以较为完整地切除病变并建立充分的引流通道,术后患者恢复快、并发症少、复发率低,值得临床推广应用。Objective To explore the surgical method and clinical effect of nasal endoscope-assisted resection of maxillary cysts and the related factors affecting the clinical symptoms of maxillary cysts.Methods The clinical data of 34 patients with maxillary cysts admitted to our department from May 2018 to May 2022 were collected to analyze the selection of surgical methods and treatment effects of nasal endoscope-assisted resection of maxillary cysts.At the same time,the visual analogue scale(VAS)score of patients’nasal and facial discomfort at different time points before and after surgery was collected to analyze its influencing factors.Results Six patients underwent endoscopic sinus fenestration surgery through the nasal floor approach;2 patients underwent endoscopic surgery through the natural ostium of the maxillary sinus approach;1 patient underwent endoscopic fenestration through the inferior nasal meatus approach;25 patients underwent endoscopic surgery through the natural ostium of the maxillary sinus combined with the prelacrimal recess approach.Postoperative follow-up for 5-24 months showed good mucosal epithe-lialization of the surgical cavity,significant relief of symptoms,unobstructed drainage of the cystic cavity,and no recurrence in these cases.The preoperative VAS scores of patients in the maxillary sinus group were significantly higher than those in the nasal floor group(t=2.242,P<0.05).The preoperative VAS scores of patients in the odontogenic maxillary cyst group were significantly higher than those in the non-odontogenic maxillary cyst group(t=2.329,P<0.05).Conclusion Nasal endoscope-assisted resection of maxillary cysts can completely remove the lesion and establish sufficient drainage channels,bringing a fast recovery,few complications,and low recurrence rate to patients.It is worthy of clinical application.

关 键 词：颌囊肿 上颌骨 内窥镜检查 鼻外科手术 治疗结果 

分 类 号：R782[医药卫生—口腔医学] R443.7[医药卫生—临床医学]