经鼻内镜手术治疗腭正中囊肿的探讨

Transnasal endoscopic surgery for median palatal cyst

目的分析腭正中囊肿的临床特点,探讨鼻内镜手术治疗的可行性。方法回顾性分析2012年1月-2022年12月在山东大学齐鲁医院耳鼻喉科手术治疗的36例腭正中囊肿患者的临床资料,女性5例,男性31例,年龄21-47岁,平均35.7岁。临床症状主要表现为鼻塞、头痛、颌面部局限性膨隆等。结果本组病人均经影像学及病理检查明确诊断,在全麻鼻内镜下行腭正中囊肿开窗引流术,术后2周开始鼻内镜复查,术后随访6个月-18个月,平均12.3个月,术后开窗边缘出血1例,予以电凝止血;无周围组织损伤及鼻腭瘘(鼻底口腔瘘)等并发症发生。结论针对腭正中囊肿的鼻内镜外科治疗,经鼻腔入路,强调术腔的开放性,有效避免囊肿完整切除对周围重要组织结构造成的损伤,有效减少囊肿复发,改善患者生活质量,缩短治愈时间。

Objective To analyze the clinical characteristics of median palatal cyst and explore the feasibility of nasal endoscopy for it.Methods The clinical data of 36 patients with median palatal cyst who received endoscopic surgery in the Department of Otorhinolaryngology,Qilu Hospital of Shandong University from January 2012 to December 2022 were retrospectively analyzed.There were 5 females and 31 males,aged 21-47 with an average of 35.7.The main clinical symptoms were nasal congestion,headache and local maxillofacial distention.Results All patients in this group were diagnosed by imaging and pathology.Fenestration and drainage of median palatal cyst were performed by nasal endoscopy under general anesthesia.Nasal endoscopic reexamination began at 2 weeks postoperatively,and kept 6-18 months(with an average of 12.3).No complications such as surrounding tissue injury and nasopalatine fistula(naso-oral fistula)occurred.Conclusion The nasal endoscopy for median palatal cyst through the nasal approach emphasizes the openness of the operative cavity and effectively avoids the injury of the surrounding important tissues caused by the complete resection of the cyst,as well as reduces the recurrence,improves the quality of life and reduces the healing time.