| 摘要: |
| 目的:探讨鼻内镜下鼻腔外侧壁切开入路治疗难治性复发性上颌窦良性病变的手术方法和临床价值。方法:回顾分析8例上颌窦筛窦手术后复发病例,其中男性6例,女性2例,年龄41～69岁，平均（55±14）岁,先前均有2～4次手术史。本次手术在全麻下进行,先从下鼻甲前缘行鼻腔外侧壁切开,解剖出鼻泪管后形成鼻泪管-下鼻甲瓣,内移形成上颌窦入路,然后在鼻内镜直视下彻底清除上颌窦病灶,最后复位鼻泪管-下鼻甲黏膜瓣,必要时行下鼻道开窗。术后均行病理排查。结果:所有患者术后均经病理证实为良性病变,排除恶性肿瘤。于术后6个月进行评价,5例治愈,3例好转。随访6~14个月均无面颊部麻木、溢泪、眶内出血、视物障碍或脑脊液鼻漏等并发症。结论:鼻内镜下鼻腔外侧壁切开入路上颌窦手术视野宽,有利于整个上颌窦腔病变彻底清除,保留了鼻泪管和下鼻甲,临床疗效满意。 |
| 关键词: 上颌窦疾病 鼻窦内镜术 鼻腔外侧壁切开入路 |
| DOI：10.3724/SP.J.1008.2009.0561 |
| 投稿时间：2008-11-27修订日期：2008-12-25 |
| 基金项目: |
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| Endoscopic nasal lateral wall dissection approach for benign lesions of maxillary sinus |
| YING Li-yun1,ZHAO Chang-qing1,2* |
| (1.Department of Otolaryngology,Eastern Hospital,Tongji University,Shanghai 200120,China;2.Department of Otolaryngology,Second Hospital,Shanxi Medical University,Taiyuan 030001) |
| Abstract: |
| Objective:To report our experience on endoscopic nasal lateral wall dissection approach for treatment of refractory benign maxillary sinus diseases.Methods:The data of 8 patients,who had relapsing maxillary diseases 2 to 4 times after maxillary sinus or ethmoid sinus surgery, were retrospectively analyzed. The patients included 6 males and 2 females,with an average age of (55±14) years（41-69 years）. Under general anesthesia the operation started from an incision in front of the inferior turbinate (IT),then the lacrimal duct(LD) was dissected to form a IT-LD flap. The flap was placed inwardly and the maxillary sinus lesion was removed under endoscope. The inferior antrostomy was performed when necessary. The possibility of maxillary sinus malignant lesions was ruled out by postoperative pathology.Results:Postoperative pathological findings confirmed that the lesions were all benign. The follow-up period ranged from 6-14 months. Five patients were cured and 3 were improved 6 months after operation.There were no complications such as cheek numbness,epiphora,orbital hemorrhage,visual disorder or cerebrospinal fluid rhinorrhea during follow-up.Conclusion:The endoscopic nasal lateral wall dissection approach provides a wider vision field and allows for a thorough removal of maxillary sinus lesions,while reserving the LD and IT. |
| Key words: maxillary sinus lesions endoscopic sinus surgery endoscopic nasal lateral wall dissection |
