鼻内镜下下鼻道黏膜瓣开窗术治疗上颌窦囊肿的效果及安全性

Efficacy and Safety of Lower Nasal Mucosal Flap Fenestration Under Nasal Endoscopy for Patients with Maxillary Sinus Cyst

目的探究鼻内镜下下鼻道黏膜瓣开窗术治疗上颌窦囊肿患者的效果及安全性。方法选取2018年1月至2021年1月新乡医学院第三附属医院耳鼻喉科收治的拟行手术治疗的114例上颌窦囊肿患者作为研究对象,根据手术方法分为对照组(n=57)、研究组(n=57)。对照组接受鼻内镜下下鼻道开窗术治疗,研究组接受鼻内镜下下鼻道黏膜瓣开窗术治疗。对比两组治疗效果、围手术期指标、疼痛程度[视觉模拟量表(VAS)]、鼻腔功能损伤程度[鼻内镜评估系统(Lund-Kennedy)]、术后并发症及复发情况。结果与对照组比较,研究组黏膜切除面积、下鼻甲骨窗面积较小(P<0.05);术后6个月研究组VAS评分、Lund-Kennedy评分均低于对照组(P<0.05);研究组术后并发症发生率[5.26%(3/57)]低于对照组[17.54%(10/57)](P<0.05)。结论采用鼻内镜下下鼻道黏膜瓣开窗术与鼻内镜下鼻道开窗术治疗上颌窦囊肿均有较好效果,与鼻内镜下下鼻道开窗术相比,鼻内镜下下鼻道黏膜瓣开窗术能减少黏膜切除,降低术后并发症发生风险。

Objective To explore the efficacy and safety of lower nasal mucosal flap fenestration under nasal endoscopy in the treatment of maxillary sinus cysts.Methods A total of 114 patients with maxillary sinus cysts who were admitted to the Department of Otolaryngology in the Third Affiliated Hospital of Xinxiang Medical University from January 2018 to January 2021 were selected as the research objects.According to surgical methods,they were divided into control group(n=57)and study group(n=57).The control group was treated with lower nasal fenestration under nasal endoscopy,and the study group was treated with lower nasal mucosal flap fenestration under nasal endoscopy.The treatment effects,perioperative indicators,degree of pain[visual analogue scale(VAS)],degree of nasal function injury[nasal endoscopy evaluation system(Lund-Kennedy)]postoperative complications and recurrence were compared between the two groups.Results Compared with the control group,the mucosal resection area and inferior turbinate window area of the study group were smaller(P<0.05).The VAS score and Lund-Kennedy score of the study group were all lower than those of the control group(P<0.05).The postoperative complication rate of the study group[5.26%(3/57)]was lower than the control group[17.54%(10/57)](P<0.05).Conclusion The lower nasal mucosal flap fenestration under nasal endoscopy and the lower nasal passage fenestration under nasal endoscopy have better curative effects in the treatment of maxillary sinus cyst.Compared with lower nasal passage fenestration,the lower nasal mucosal flap fenstration can reduce mucosal resection and reduce the risk of postoperative complications.