上颌窦鳞癌的早期诊断

The early diagnosis of squamous cell carcinoma of the maxillary sinus (SCMS)

目的 提高上颌窦鳞癌的早期诊断水平。方法 本文分析了 478例上颌窦鳞癌的首发症状、临床分期及其与疗效的关系。结果 Ⅲ、Ⅳ期的晚期病例占 95 .18% (4 5 5 / 478)。首发症状以面部肿胀、疼痛、鼻腔异常分泌物、鼻塞、上牙松动脱落为常见 ,常被误诊为鼻窦炎、牙髓牙周炎、三叉神经痛等。结论 首发症状不具特异性是上颌窦鳞癌误诊的主要原因。X线片尤其是Water氏位片可以作为常规及普查时应用 ,CT、MIR是理想的诊断方法。上颌窦内窥镜检查创伤小 ,能达到确诊目的 。

Objective To develop the level of early diagnose of SCMS.Methods An analysis of 478 cases with squamous cell carcinoma of SCMS and relationship of early symptom,the clinical stage and the curative effect.Results Among them,the cases in advanced stage were 95.18% (455/478),157 cases were in stage Ⅲ,298 in stage Ⅳ.The early symptoms included:the swelling of check,ache,snuffle,nasal abnormal mucus and the loose or even loss of the teeth maxillary,which often were incorrectly diagnosed as paranasal sinusitis,pulpitis,periodontitis trigeminal nerve algesia et al.Conclusion It is the main reason of erroneous diagnosis that the early symptoms have no specificity.The X-ray especiallythe Water's can be used in common diagnosis and general surveying;and the idealway of diagnosis is by CT or MR.It is recommend that endoscope of maxillary sinus be used for the diagnosis.