鼻内镜下中鼻道联合下鼻道扩大泪前隐窝入路切除上颌窦良性病变

Combined middle meatus and expand prelacrimal recess-maxillary ainus approach for endoscopic maxillary sinus surgery

目的:探讨鼻内镜下联合入路上颌窦良性病变的手术方法和临床价值。方法:回顾性分析经鼻内镜下中鼻道联合下鼻道泪前隐窝入路手术治疗27例单侧上颌窦良性病变患者临床资料,观察临床效果。结果:所有患者术中或术后均经病理证实为良性病变,排除恶性肿瘤。随访12～24个月,所有患者术腔上皮化,下鼻甲形态良好,均无溢泪发生。仅1例乳头状瘤术后2个月复发,局部处理后随访至今未见复发。结论:经鼻内镜下鼻道扩大泪前隐窝入路治疗上颌窦良性病变创伤小,手术视野广阔清晰,能够准确完整地清除病变,术腔符合鼻腔的生理结构和功能需要,具有很高的临床实用价值。

Objective：To study surgical techniques and clinical applications of the intranasal endoscopic combined approach in maxillary sinus benign lesions surgery.Method：A retrospective clinical analysis of 27 patients whose unilateral maxillary sinus benign lesions operated by the intranasal endoscopic middle meatus with inferior meatus tears recess approach surgical treatment was studied.Result：Benign lesions were confirmed by pathology in all patients before and after surgery as to rule out malignancy.All patients had been followed up for 12 to 24 months.Twenty-seven cases resulted in normal luminal epithelium and inferior turbinate shape after surgery.Only one case of papilloma relapsed 2 months after operation.So far,the papilloma has not recurred after the second surgery.There were no epiphora in all cases.Conclusion：Endonasal endoscopic expand anterior tears recess approach have great and clear view.This approach made us accurately,mini-invade and completely remove the maxillary sinus benign lesions.It is a physiological and functional surgery and has great advantage in the nasal cavity disease treatment.