中鼻道联合泪前隐窝入路治疗上颌窦良性病变的疗效分析

Curative Effect of Middle Nasal Canal Combined with Anterior Lacrimal Recess Approach in the Treatment of Maxillary Sinus Benign Lesions

目的探讨分析中鼻道联合泪前隐窝入路治疗上颌窦良性病变的临床疗效。方法对2021年12月—2023年6月在息烽县人民医院耳鼻喉科住院手术治疗的68例上颌窦良性病变患者的临床资料进行回顾性分析,所有患者均在鼻内镜下经中鼻道扩大上颌窦自然口,经扩大的上颌窦口不能完全切除清理上颌窦内病变组织,再联合泪前隐窝入路切除清理上颌窦内病变组织,分析病理检出情况以及临床治疗效果、术后并发症发生率和复发率。结果患者均接受经中鼻道联合泪前隐窝入路行上颌窦良性病变切除清理术,术后组织病理学共计检出曲霉菌感染18例,息肉12例,囊肿28例,内翻性乳头状瘤2例,骨瘤1例,神经鞘瘤合并血管瘤1例,霉菌伴囊肿5例,霉菌伴息肉1例,所有患者术后随访6个月以上,随访显示术后患者未出现溢泪等并发症,中鼻道上颌窦开口引流通畅,术后均未见病情复发,手术治愈率达100%。结论中鼻道联合泪前隐窝入路治疗上颌窦良性病变的临床疗效显著,可有效提高临床治愈率,具有较高的可靠性和安全性,能够有效控制并发症发生率和复发率。

Objective To investigate the clinical efficacy of middle nasal meatus combined with prelacrimal recess ap⁃proach in the treatment of benign lesions of maxillary sinus.Methods The clinical data of 68 patients with benign maxillary sinus lesions who underwent surgical treatment in the Department of Otolaryngology,Xifeng County People's Hospital from December 2021 to June 2023 were retrospectively analyzed.All patients underwent nasal endoscopy.The natural orifice of the maxillary sinus was expanded through the middle nasal meatus.The enlarged maxillary sinus orifice could not completely remove and clean the diseased tissue in the maxillary sinus,and then combined with the anterior lacrimal recess approach to remove and clean the diseased tissue in the maxillary sinus.The pathological de⁃tection,clinical treatment effect,postoperative complication rate and recurrence rate were analyzed.Results All pa⁃tients underwent maxillary sinus benign lesion resection and debridement through the middle nasal meatus combined with prelacrimal recess approach.Postoperative histopathological examination showed 18 cases of Aspergillus infec⁃tion,12 cases of polyps,28 cases of cysts,2 cases of inverted papilloma,1 case of osteoma,1 case of schwannoma with hemangioma,5 cases of mold with cysts,and 1 case of mold with polyps.All patients were followed up for more than 6 months.The follow-up showed that there were no complications such as epiphora after operation.The drainage of the maxillary sinus opening in the middle nasal meatus was unobstructed,and there was no recurrence of the dis⁃ease after operation.The cure rate of the operation was 100%.Conclusion The clinical efficacy of middle nasal me⁃atus combined with anterior lacrimal recess approach in the treatment of benign lesions of maxillary sinus is signifi⁃cant,which can effectively improve the clinical cure rate,with high reliability and safety,and can effectively control the incidence of complications and recurrence rate.