复发性上颌窦后鼻孔息肉的临床特点及治疗

Clinical characteristics and treatment of recurrent antrochoanal polyps

目的探讨复发性上颌窦后鼻孔息肉患者的临床特点及治疗方式。方法回顾性分析2014年1月~2017年5月12例我科收住的复发性上颌窦后鼻孔息肉患者的临床特征、起源、手术方式及疗效。结果12例患者中男性7例,女性5例,年龄11~54岁,平均36.25,复发前手术方式均为功能性鼻内镜手术,平均复发时间为3.8年,上颌窦内囊肿来源于后外侧壁6例及内侧壁3例采取鼻内镜下上颌窦中鼻道扩大开窗术,囊肿起源于前壁1例及底壁2例患者采用鼻内镜下泪前隐窝入路,囊肿起源部位与上颌窦壁粘连。随访17月~4年,无复发病例。结论对于复发性上颌窦后鼻孔息肉可以根据上颌窦内囊肿起源的位置选择合适的手术方式,鼻内镜下中鼻道扩大开窗术及鼻内镜下泪前隐窝入路是治疗复发性上颌窦后鼻孔息肉有效的方法。

Objective To investigate the clinical characteristics and treatment of recurrent antrochoanal polyps.Methods A retrospective analysis was made on the clinical features,origins,surgical procedures and outcomes of 12 patients with recurrent antrochoanal polyps treated in our department from January 2014 to May 2017.Results There were 7 males and 5 females aged 11~54 years with an average age of 36.25 years.The primary surgery of recurrent patients was functional endoscopic surgery.The mean recurrence time was 3.8 years.Six cases of maxillary sinus cyst originated from posterolateral wall and three cases from internal wall were treated with endoscopic wide middle meatal antrostomy.Two cases of anterior wall and one case of bottom wall were treated by transnasal prelacrimal recess approach.Follow up in 17~48 months,no recurrence.Conclusion For recurrent antrochoanal polyps,appropriate surgical procedures can be selected according to the location of the origin of the cyst in the maxillary sinus.Endoscopic wide middle meatal antrostomy and transnasal prelacrimal recess approach are effective methods for the treatment of recurrent antrochoanal polyps.