单侧上颌窦良性占位性病变手术入路临床分析与疗效

Clinical analysis of surgical approaches and efficacy of benign occupying lesion of unilateral maxillary sinus

目的：探讨单侧上颌窦良性占位性病变的手术治疗方法及疗效。方法：对2005—06—2012-06接受鼻内镜手术治疗且有完整随访资料的84例单侧上二颌窦良性占位性病变患者的临床资料进行分析。其中采用单纯鼻内镜手术59例，采用鼻内镜联合改良Caldwell-Luc术式18例，采用鼻内镜联合F鼻道开窗15例，采用鼻内镜F泪前隐窝入路12例，并对术后情况进行随访。结果：全部患者随访4个月～7年，仅5例在手术后复发，其余81例在随访期内均未见复发。所有患者术前行鼻内镜、CT或MRI检查，并经术后病理检查证实。结论：上颌窦良性占位性病变以囊肿、真菌性上颌赛炎多见；根据上颌窦良性占位性病变的不同临床特点，可采用不同手术人路，既可有效治愈上颌窦病变，又可最大限度地减少手术创伤。鼻内镜手术是治疗上颌窦良性占位性病变的首选术式。

Objective：To investigate the therapeutic methods and efficacy of benign occupying lesion of unilat eral maxillary sinus. Method： The clinical data of 84 patients treated with endoscopic surgery from June 2005 to June 2012 were retrospectively analyzed. Among these patients, 39 cases were treated by endoscopic surgery only, 18 cases were treated by endoscopic plus modifided Caldwell Luc technique, 15 cases were treated by endoscopic plus inferior meatus antrostomy approach, and 12 cases were treated by endoscopic anterior lacrimal recess ap proach . All patiems were followed up postoperativelly. Result： All cases were followed up from 4 months to 7 years. Among them,81 cases had no recurrence,whereas three cases recurred during the follow-up period. All ca ses were preoperatively diagnosed by CT, MRI or intranasal endoscopy, which were confirmed by pathological examination postoperatively. Conclusion： Maxillary cyst and fungalmaxillary sinusitis are the major types of benign occupying lesions of maxillary sinus. According to different clinical features of benign occupying lesions of maxillary sinus,different surgical approaches should be adopted. It can not only effcectively cure maxillary sinus le sions,but aslo minimize the operation trauma. Endoscopic sinus surgery is the preferred technique for treating benign occupying lesions of maxillary sinus.