上颌骨囊肿并内翻性乳头状瘤1例并文献复习  

Maxillary cyst with inverted papilloma:a case report and literature review

作　　者：石忠刚 蔡晓岚[1,3] 李学忠[1,3] 张立强[1,3] 冯昕[1,3] SHI Zhonggang;CAI Xiaolan;LI Xuezhong;ZHANG Liqiang;FENG Xin(Department of Otorhinolaryngology,Qilu Hospital of Shandong University,Jinan 250012,Shandong,China;Department of Otorhinolaryngology,JI'NAN Zhangqiu District People's Hospital,Jinan 250200,Shandong,China;NHC Key Laboratory of Otorhinolaryngology(Shandong University),Jinan 250012,Shandong,China)

机构地区：[1]山东大学齐鲁医院耳鼻咽喉科,山东济南250012 [2]济南市章丘区人民医院耳鼻咽喉科,山东济南250200 [3]国家卫生健康委员会耳鼻喉科学重点实验室(山东大学),山东济南250012

出　　处：《山东大学耳鼻喉眼学报》2025年第1期123-129,共7页Journal of Otolaryngology and Ophthalmology of Shandong University

基　　金：山东省自然科学基金(ZR2021MH117);济南市卫生健康委员会科技计划项目(2023-2-175)。

摘　　要：目的探讨发生于上颌窦的鼻息肉、内翻性乳头状瘤并颌骨囊肿的临床特点、诊疗要点、手术方法。方法回顾性分析1例发生于上颌窦的鼻息肉、内翻性乳头状瘤及上颌骨囊肿患者病历资料,并复习相关文献进行总结。结果本例上颌骨囊肿合并内翻性乳头状瘤并鼻息肉的病例罕见,术中经中鼻道上颌窦自然口开放上颌窦切除鼻息肉,发现息肉位于上颌窦口前下方,上颌窦顶壁处肿物质脆、灰白色,术中快速病理证实为内翻性乳头状瘤。70°镜检查发现上颌骨骨囊肿位于上颌窦底壁,遂经泪前隐窝入路完成肿物的切除及上颌骨骨囊肿的开窗引流,术后无眶内并发症发生。结论针对上颌窦内翻性乳头状瘤及息肉鼻内镜外科治疗,经鼻腔入路强调术腔的开放性,经泪前隐窝入路上颌窦手术可处理传统手术难以接近的区域,有针对性的处理可彻底切除肿瘤组织,有效减少肿瘤复发。对于颌骨囊肿,采取开窗引流术可有效降低手术创伤,避免囊肿完整切除对周围重要组织结构造成的损伤,手术操作空间大,视野开阔,囊肿均得以彻底开放引流,有效减少囊肿复发,减少并发症发生,改善患者生活质量,缩短治愈时间。Objective This study aims to investigate the clinical features,diagnosis and treatment of nasal polyps,inverting papilloma and maxillary bone cyst occurring in the maxillary sinus.Methods We retrospectively analysed the medical records of a patient with nasal polyps,inverted papilloma and maxillary bone cyst from the maxillary sinus and reviewed and summarised the relevant literature.Results This case report presents a rare occurrence of a maxillary sinus cyst combined with an inverted papilloma and a nasal polyp.During surgical excision of the nasal polyps,they were found to be located in the anterior and lower part of the maxillary sinus.In addition,a friable grey-white swelling was found on the upper wall of the maxillary sinus,which was quickly confirmed to be a varus papilloma.The maxillary cyst was also located in the inferior wall of the maxillary sinus using 70°microscopy.The maxillary cyst was fenestrated and the tumour was resected via the anterior lacrimal canal approach.There were no complications during the procedure.Conclusion For the endoscopic surgical treatment of inverted papillomas and polyps in the maxillary sinus,the nasal approach emphasises the openness of the operative cavity.In addition,surgery in the maxillary sinus through the anterior lacrimal recess can treat areas that are difficult to access through traditional surgery.Targeted treatment can completely remove tumour tissue and effectively reduce tumour recurrence.For jaw cysts,fenestration and drainage can effectively reduce surgical trauma and avoid damage to surrounding important tissue structures caused by complete cyst resection.This procedure provides a large operative space and wide field of view,allowing complete cyst drainage and reducing the risk of recurrence and complications.It can also improve patients'quality of life and reduce recovery time.

关 键 词：上颌窦 鼻息肉 内翻性乳头状瘤 颌骨囊性病变 鼻内镜 

分 类 号：R765.4[医药卫生—耳鼻咽喉科] R739.62[医药卫生—临床医学]