异位牙及多生牙并发上颌骨囊肿的临床分析  

Clinical analysis of maxillary cysts complicatedby ectopic and supernumerary teeth

作　　者：王宇[1] 廖红明 蒋玉欢 郑志刚[1] 何本超[1] WANG Yu;LIAO Hongming;JIANG Yuhuan;ZHENG Zhigang;HE Benchao(Department of Otolaryngology,Tianmen First People’s Hospital,Tianmen 431700,China)

机构地区：[1]天门市第一人民医院耳鼻咽喉科,湖北天门431700

出　　处：《中国耳鼻咽喉颅底外科杂志》2024年第1期93-97,共5页Chinese Journal of Otorhinolaryngology-skull Base Surgery

摘　　要：目的 探讨异位牙及多生牙并发上颌骨囊肿的病因、症状、诊断及治疗。方法 回顾近5年天门市第一人民医院收治的6例异位牙及多生牙合并上颌骨囊肿的临床质料,并总结其诊治特点。结果 6例患者共有7颗异位牙和多生牙,均并发上颌骨囊肿,1颗左上尖牙异位至左鼻腔,1颗左上前磨牙异位至左眶底,1颗左上尖牙异位至左上颌窦泪前隐窝区域,1颗为左侧上颌窦底异位多生牙,3颗为右上颌骨前部多生牙。5例患者1次手术成功,1例患者初次手术仅处理囊肿,未处理异位牙,2个月后出现口腔瘘,8个月后再次手术去除异位牙。3例患者鼻内镜下经鼻入路手术,2例患者采取Caldwell-Luc入路手术,1例鼻内镜结合Caldwell-Luc入路手术;2例患者Caldwell-Luc入路术后出现面部麻木感3个月后缓解。6例患者均无复发及其他并发症。结论 异位牙及多生牙并发上颌骨囊肿常表现为面部隆起,可首诊于耳鼻咽喉科,耳鼻咽喉科医生需重视,避免漏诊。术者需结合手术经验,根据牙齿的位置及囊肿累及范围,选择合理的手术入路;鼻内镜下经鼻入路较Caldwell-Luc入路损伤小,并发症发生率较低。Objective To explore the etiology,symptoms,diagnosis and treatment of ectopic teeth and supernumerary teeth complicated with maxillary cyst.Methods It was reviewed for the clinical material of 6 cases of ectopic teeth or supernumerary teeth with maxillary cysts treated by Tianmen First People’s Hospital in the past 5 years.And the characteristics of diagnosis and treatment were summarized.Results There were 7 ectopic teeth and supernumerary teeth in 6 patients,all of which were complicated with maxillary cyst,1 left upper canine was ectopic to left nasal cavity.In 6 patients,one left premolar was ectopic to left orbital floor,one left upper canine ectopic to left maxillary sinus lacrimal recess area.There was one ectopic supernumerary teeth in the left maxillary sinus floor,and three supernumerary teeth in the right maxillary front.Five patients were successfully operated on once.One patient was treated only the cyst,but not the ectopic tooth.Oral fistula of the patient occurred 2 months later,and the ectopic teeth were removed again 8 months later.Transnasal approach under nasal endoscope was performed in 3 patients.Two patients underwent Caldwell-Luc approach,and one underwent endoscopic sinus surgery combined with Caldwell-Luc approach and resolved after 3 months.Two patients developed facial numbness after Caldwell-Luc approach for 3 months,There was no recurrence or other complications in 6 patients.Conclusions Ectopic teeth and supernumerary teeth complicated with maxillary cyst often show facial protuberance.Such patients can be the first visit to the Otolaryngology,otolaryngologists need to pay great attention to avoid missed diagnosis.According to the position of the teeth and the extent of the cysts involved and the experience of surgery,a reasonable surgical approach was chosen.Compared with the Caldwell-Luc approach,the endoscopic transnasal approach has less injury and lower complication rate.

关 键 词：上颌窦 异位牙 多生牙 上颌骨囊肿 

分 类 号：R765.4[医药卫生—耳鼻咽喉科]