鼻内镜下泪前隐窝入路清除上颌窦内病变的观察

发布时间：2018-11-18 09:07

【摘要】：目的探讨经中鼻道开窗+泪前隐窝入路彻底清除上颌窦内病变的必要性。方法对30例54侧上颌窦病变,70°鼻内镜直视下经中鼻道开窗,查找并清除病变后,再行泪前隐窝入路,彻底清除上颌窦内残留病变。结果 (1)经中鼻道开窗可以窥及,但无法彻底清除上颌窦内病变9例14侧,约占总侧数的25.93%。而且经泪前隐窝入路窥及病变较之经中鼻道开窗所见更为广泛;(2)经中鼻道开窗清除上颌窦内病变,未窥及残留后,再行泪前隐窝入路,仍然发现18例32侧存有病变,约占总侧数的59.26%。结论 70°鼻内镜下经中鼻道开窗彻底清除上颌窦内病变,不仅困难,而且存在视觉死角,经泪前隐窝入路既能看清上颌窦内各壁,又能彻底清除上颌窦内病变。因此,在可能出现上颌窦病变残留时,有必要采用"中鼻道开窗+泪前隐窝入路"的双径路手术方式。
[Abstract]:Objective to explore the necessity of removing the maxillary sinus lesions thoroughly through the approach of anterior lacrimal recess through the middle nasal canal. Methods in 30 cases (54 sides) of maxillary sinus lesions, 70 掳endoscopic fenestration was performed through the middle nasal canal. After searching and clearing the lesions, the anterior lacrimal recess approach was used to thoroughly remove the residual lesions in the maxillary sinus. Results (1) 9 cases (14 sides) of maxillary sinus lesions could not be completely removed, accounting for 25.93% of the total side. In addition, the anterior lacrimal recess and pathological changes were more extensive than those seen through the middle nasal canal. (2) 32 sides of 18 cases (59.26%) were found to have lesions in the 32 sides of 18 cases (59.26% of the total) after the anterior lacrimal recess approach was performed after the maxillary sinus was cleared through the middle nasal canal. Conclusion 70 掳endoscopic fenestration through the middle nasal canal is not only difficult to remove the lesions in the maxillary sinus, but also has the visual dead angle. The anterior lacrimal recess approach can not only see the walls of the maxillary sinus, but also thoroughly remove the lesions in the maxillary sinus. Therefore, when residual maxillary sinus lesions may occur, it is necessary to adopt the "middle nasal canal fenestration anterior lacrimal recess approach" dual approach.
【作者单位】：清华大学医院耳鼻喉科;广州市耳鼻咽喉头颈外科医院;
【分类号】：R765.9

【相似文献】