鼻内镜下经鼻底开窗治疗上颌骨牙源性囊肿的临床分析  

Clinical analysis of the treatment of maxillary odontogenic cyst by nasal endoscope fenestration through nasal base

作　　者：唐志元 曾宪海 张秋航 李定波 王再兴 TANG Zhiyuan;ZENG Xianhai;ZHANG Qiuhang;LI Dingbo;WANG Zaixing(Department of Otolaryngology,Longgang E.N.T.Hospital&Shenzhen Key Laboratory of E.N.T.,Institute of E.N.T.,Shenzhen,518172,China)

机构地区：[1]深圳市龙岗区耳鼻咽喉医院耳鼻咽喉科,深圳市耳鼻咽喉研究所,广东深圳518172

出　　处：《临床耳鼻咽喉头颈外科杂志》2023年第5期333-337,共5页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：深圳市医学重点学科建设经费资助(No:SZXK039);深圳市龙岗区科技发展专项资金(No:LGKCYLWS2020097)。

摘　　要：目的:探讨鼻内镜下经鼻底开窗治疗上颌骨牙源性囊肿的手术进路及方法的可行性及临床效果。方法:回顾性分析鼻内镜下经鼻底开窗治疗23例上颌骨牙源性囊肿的临床资料。所有患者术前均行鼻内镜、CT检查。手术先经鼻底开窗切除囊肿顶壁黏膜,减压并清除囊液,修整及扩大鼻底骨性开口至囊肿边缘,再观察术中情况及术后疗效。结果:全部患者均能在鼻内镜直视下良好暴露,最大限度地切除囊肿顶壁使囊腔与鼻底沟通,术后无鼻泪管损伤、无鼻甲萎缩、坏死及面部麻木等并发症。随访6~12个月,所有患者术后临床症状逐渐消失,下鼻甲形态良好,囊腔引流通畅,囊壁上皮化,未见囊肿复发。结论:鼻内镜下经鼻底开窗治疗上颌骨牙源性囊肿,手术操作方便、创伤小、并发症少且疗效满意,值得临床推广。Objective:To investigate the feasibility and clinical effect of the surgical approach and method of transnasal fenestration under nasal endoscope for the treatment of maxillary odontogenic cyst.Methods:The clinical data of 23 cases with maxillary odontogenic cysts treated by nasal endoscopy through nasal fenestration were retrospectively analyzed.All cases underwent nasal endoscopy and CT examination before the operation.The mucosal membrane of the parietal wall of the cyst was excised through fenestration of the nasal base.The cyst fluid was removed by decompression,and the bony opening of the nasal base was trimmed and enlarged to the edge of the cyst.The intraoperative and postoperative effects were observed.Results:All cases were well exposed under the direct vision of nasal endoscope.The top wall of the cyst was removed to maximize the communication between the cyst cavity and the nasal floor.There were no complications such as nasolacrimal duct injury,turbinate atrophy,necrosis,and facial numbness.All patients were followed up for 6-12 months,and the clinical symptoms gradually disappeared after surgery.The inferior turbinate was in good shape,the cyst cavity was smooth,the cyst wall was determined,and no cyst recurrence was observed.Conclusion:The treatment of odontogenic cyst of maxilla under nasal endoscope through nasal fenestration is convenient.It has less trauma,fewer complications and a satisfactory curative effect,which is worthy of clinical promotion.

关 键 词：上颌骨牙源性囊肿 鼻内镜检查 经鼻开窗术 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]