上颌窦后鼻孔息肉的起源及多种入路处理上颌窦后鼻孔息肉疗效的比较

发布时间：2018-05-17 12:37

本文选题：鼻息肉 + 上颌窦　；参考：《临床耳鼻咽喉头颈外科杂志》2016年03期

【摘要】：目的:探讨上颌窦后鼻孔息肉的起源及疗效。方法:对57例上颌窦后鼻孔息肉患者进行术前鼻内镜检查、冠状位和轴位CT扫描;分别采用鼻内镜下中鼻道上颌窦开窗术、联合中鼻道及下鼻道开窗术、联合鼻内镜下鼻腔侧壁切开入路及中鼻道开窗3种手术方式;术中鼻内镜下观察后鼻孔息肉与上颌窦内病变的关系、组织病理学检测结果;术后进行随访。结果:57例上颌窦后鼻孔息肉起源于同侧上颌窦囊肿,22例中鼻道上颌窦开窗术,复发2例;17例联合中鼻道及下鼻道开窗术,复发1例;18例联合鼻内镜下鼻腔侧壁切开入路及中鼻道开窗术,治愈率100%。结论:上颌窦后鼻孔息肉起源于上颌窦内囊肿,囊壁由窦口脱出于中鼻道及鼻咽部形成息肉,常见于单侧,偶发双侧。鼻内镜下中鼻道上颌窦开窗术、联合中鼻道及下鼻道开窗术有很好的疗效,对于上颌窦前壁的囊肿联合鼻内镜下鼻腔侧壁切开入路可获得较好的视野,有利于病变的完整切除。
[Abstract]:Objective: to investigate the origin and curative effect of posterior nostril polyp of maxillary sinus. Methods: Fifty-seven patients with nasal polyps of posterior maxillary sinus underwent preoperative nasal endoscopy, coronal and axial CT scanning, middle maxillary sinus fenestration under nasal endoscope, combined with middle nasal canal and inferior nasal canal fenestration, respectively. The relationship between posterior nostril polyp and maxillary sinus lesions was observed under nasal endoscope and the results of histopathological examination were followed up. Results 57 cases of posterior nostril polyps of maxillary sinus originated from ipsilateral maxillary sinus cyst 22 cases of middle nasal canal maxillary sinus fenestration, 2 cases of recurrence of 17 cases combined with middle nasal canal and inferior nasal canal fenestration. There were 18 cases of recurrence combined with endoscopic incision of the lateral wall of nasal cavity and fenestration of middle nasal canal. The cure rate was 100%. Conclusion: the posterior nasal polyp of maxillary sinus originated from the cyst in the maxillary sinus, and the cyst wall protruded from the sinus orifice to the middle nasal canal and nasopharynx to form polyps. Endoscopic fenestration of maxillary sinus, combined with middle nasal canal and inferior nasal canal fenestration has good curative effect. For the cyst of anterior wall of maxillary sinus combined with lateral wall incision of nasal cavity under nasal endoscope, a better visual field can be obtained, which is beneficial to the complete excision of the lesion.
【作者单位】：合肥市第二人民医院耳鼻咽喉头颈外科;
【分类号】：R765.9

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