鼻窥镜下三种术式治疗上颌窦囊肿效果分析

Analysis of effect of three under nasal endoscope surgery in the treatment of maxillary sinus cyst

目的：探讨鼻窥镜下三种手术方式治疗上颌窦囊肿的临床疗效。方法选择上颌窦囊肿患者95例，分别采用上颌窦窦口开放扩大术、下鼻道上颌窦开窗术以及上颌窦前壁开窗术三种手术方式进行治疗，术后随访1年，分析三种手术方式的临床疗效。结果经上颌窦窦口开放扩大术39例，痊愈37例，2例复发；经下鼻道上颌窦开窗术27例，痊愈26例，1例复发；经上颌窦前壁开窗术29例，29例痊愈；三种手术方式治愈率差异无统计学意义（P ＞0．05）。结论治疗上颌窦囊肿术式的选择应根据囊肿的部位、大小以及是否伴有鼻-鼻窦疾病等多种因素确定。囊肿靠近窦口周围、窦腔外侧壁或伴有鼻窦疾病的上颌窦囊肿可采用上颌窦窦口开放扩大径路进行手术；靠近窦腔内侧壁、底壁的可采用下鼻道开窗径路；靠近窦腔前壁以及囊肿巨大或复发者可选择上颌窦前壁开窗手术径路；目的是达到彻底摘除囊肿，减轻组织损伤和并发症的发生。

Objective To explore three under nasal endoscope surgery treatment the clinical curative effect of maxillary sinus cyst.Methods 95 cases of maxillary sinus cyst patients were chosen,the maxillary sinus were used respectively to open to expand,the nasal passages of maxillary sinus fenestration and maxillary sinus anterior wall fen-estration three types of surgical treatment,postoperative follow -up of 1 year,the clinical curative effect of three kinds of operation method were analyzed.Results The maxillary sinus mouth open expansion of 39 cases during operation,37 cases were cured,2 cases of recurrence;The nasal passages under the maxillary sinus fenestration 27 cases, 26 cases cured,1 case of recurrence;The maxillary sinus anterior wall fenestration 29 cases,29 cases healed;Three kinds of operation cure rate difference had no statistical significance（P 〉0.05）.Conclusion The treatment of max-illary sinus cyst operation should be selected according to the location and size of cysts and whether the various associ-ated withnasal sinuses diseases and other factors determine the.Maxillary sinus cyst neararound the maxillary sinus, sinus cavity lateral wall or with sinus disease can use theostium of maxillary sinus extending open surgery path;near the sinus cavity innerwall and the bottom wall can use windowing of the inferior nasal meatus approach;near the front wall of sinus cavity and large cysts or recurrence can be choice ofmaxillary sinus by fenestration operation path;the purpose is to remove the cystoccurs completely,reduce tissue injury and complications.