53例上颌窦根治术患者回顾分析

Retrospective analysis of 53 cases undergoing Caldwell-Luc operation

目的：回顾上颌窦根治术后患者的长期并发症情况，归纳该术式不足，并提出今后的改进措施。方法：回顾2006年1月-2011年1月间行上颌窦根治术的住院病例，随访其长期并发症，包括面部麻木、面部感觉异常、肿胀（感）、鼻塞、面部疼痛、眼部不适、开口受限及复发，评价患者对手术的满意度。结果：53例患者的诊断以上颌窦慢性炎症和上颌窦瘘为主，42例（男22，女20）接受随访的患者，年龄为13。79岁f平均43岁），随访期为16～75个月，18例02．86％）患者术后出现不同程度的长期并发症，其中5例（11．90％）术后复发、9例（21．43％1对手术效果不满意。结论：上颌窦根治术后并发症的发生率高、复发率高。随着微创观念和功能性外科理念的发展．以及内镜、超声骨刀等新技术的应用．应以保存上颌窦功能及外形的术式替代传统的根治术。

PURPOSE： To review the long-term complications of patients undergoing Caldwell-Luc operation, and to summary the shortcomings of this surgical procedures and propose measures for improvements. METHODS： Hospitalized cases who underwent Caldwell-Luc operation from January 2006 to January 2011 at the Department of Oral Surgery, Shanghai Ninth People＇s Hospital were reviewed, and follow-up of long-term complications including facial numbness, facial paresthesia, swelling, nasal congestion, facial pain, eye discomfort, limited mouth opening and relapse, as well as satisfaction of the patients for surgical outcomes were recorded and analyzed. RESULTS： Preoperative diagnoses of 53 cases were mainly chronic inflammation of the maxillary sinus and maxillary sinus fistula. Forty-two patients （22 males, 20 females） aged 13 to 79 years （mean 43 years）, the follow-up period was 16 to 75 months. Eighteen cases （42.86%） had long-term complications with varying degrees, among which 5 cases （11.90%） had relapse, 9 cases （21.43%） were not satisfied with the surgical results. CONCLUSION： There is a high recurrence rate and incidence of postoperative complications after Caldwell-Lue operation. As the development of minimally invasive and functional surgery, and application of new technologies such as endoscope and piezoelectric surgery, traditional Caldwell-Luc operation substituted with minimally invasive surgery which preserves function and morphology.