功能性鼻内镜术联合游离钩突黏膜骨瓣修补口腔上颌窦瘘的近期疗效观察

Short-term Efficacy of Functional Nasal Endoscopic Surgery Combined with Free Uncinate Process Mucosal Bone Flap for Oroantral Fistula Repair

目的:分析功能性鼻内镜术联合游离钩突黏膜骨瓣修补口腔上颌窦瘘的近期疗效。方法:选择2017年1月-2020年1月笔者医院65例并发上颌窦炎的口腔上颌窦瘘患者。给予所有患者功能性鼻内镜术联合游离钩突黏膜骨瓣修补治疗,随访1年。记录患者住院指标、调查患者满意度、术后并发症、治愈率及术后复发率,随访过程中记录患者上颌窦情况。结果:经治疗后65例患者平均住院时间(8.20±2.32)d,平均住院费用8069.75元。随访1年后,所有患者瘘口、瘘道均愈合,无鼻窦炎症状,鼻腔清洁,无脓性分泌物,上颌窦开口通畅,无局部塌陷,无复发病例。有83.08%(54/65)患者非常满意,12.31%(8/65)患者较为满意,4.62%(3/65)患者满意,无不满意患者。65例患者手术均成功,治愈率100%。术后无严重并发症。结论:采用功能性鼻内镜术联合游离钩突黏膜骨瓣治疗合并上颌窦炎的口腔上颌窦瘘患者有较高治愈率,患者满意度高,术后无严重并发症发生,颌窦相关情况良好,降低患者住院时间,减少患者经济负担。

Objective To investigate the short-term efficacy of functional nasal endoscopic surgery combined with free uncinate process mucosal bone flap for oroantral fistula repair.Methods Sixty-five patients with oroantral fistula complicating maxillary sinusitis underwent functional nasal endoscopic surgery combined with free uncinate process mucosal bone flap in our hospital from January 2017 to January 2020 were enrolled.All patients received a one year follow-up.Various indexes were recorded,including hospitalization index,patient satisfaction,postoperative complications,cure rate,postoperative recurrence rate and maxillary sinus status.Results After treatment,the average length of hospital stay was(8.20±2.32)d,and the average cost of hospitalization was 8069.75 yuan.One year follow-up showed that all patients had healed fistulas and fistulae,with no sinusitis symptoms,clean nasal cavity,no purulent secretions,unobstructed maxillary sinus openings,no local collapse and no recurrence.Among all patients,83.08%(54/65)of patients were well satisfied,12.31%(8/65)were relatively satisfied,and 4.62%(3/65)were generally satisfied,and there were no unsatisfied patients.Operations were successful in all patients,with an overall cure rate of 100%.No serious complications occurred after surgery.Conclusion Treatment of oroantral fistula patients complicating maxillary sinusitis by functional nasal endoscopic surgery combined with free uncinate process mucosal bone flap has a high cure rate,high patient satisfaction,and no serious post-operative complications;moreover,patients have good maxillary sinus related conditions,short hospital stay length and low economic burden.