牙源性鼻旁瘘管(附6例报告)

Odontogenic paranasal fistula: a report of six cases

目的探讨上颌尖牙根尖炎并发鼻旁瘘管的诊断和治疗方法。方法对6例上颌尖牙根尖炎并发鼻旁瘘管进行回顾分析。6例患者行鼻部CT或X线拍片检查未见明显异常,4例误诊为上颌骨骨髓炎、皮脂腺囊肿感染和基底细胞癌等;2例行牙X线摄片检查确诊为牙源性鼻旁瘘管;手术治疗采用局部切除缝合、拔除病源牙、搔刮根尖创面,清除病灶。结果6例患者面部切口全部I期愈合,经过2~10年追踪观察,瘘管未再复发。结论鼻旁瘘管应首先考虑牙源性疾病所致,进行口腔科检查有助于减少误诊。

Objective To explore the diagnosis and treatment of apicitis of the maxillary canine complicated with paranasal fistula. Methods The clinical data of 6 patients with apicitis of the eye tooth complicated with paranasal fistula were retrospectively analysed. No abnormality was found in the nasal CT or X-ray images. 4 patients were misdiagnosed as osteomyelitis of the maxilla, infectionus ofsebaceous cyst or basal cell carcinoma. 2 patients underwent dental filming and were finally diagnosed as paranasal fistula. In the operations, all were locally ectomized and sutured, the diseased teeth were pulled out, and the raw surfaces of the root tip were scoraped to clean the focus of infection. Results The prospo-cut of all 6 cases ended up with primary healing, and after 2 to 10 years follow-up, no recurrence was found. Condusions Paranasal fistula may be caused by odongenic diseases and so stomatological examination is necessary for minimizing the misdiagnosis rate.