唇龈沟带蒂肌肉瓣修复口腔上颌窦瘘

Repair of oral superior frontal sinus fistula with Labiogingival sulcus pedicled muscle flap

目的评价唇龈沟带蒂肌肉瓣修复口腔上颌窦瘘的临床效果。方法回顾性的分析我院诊治的15例口腔上颌窦瘘患者,其中男性9例,女性6例,年龄25~56岁,5例为上颌磨牙拔除后出现,为陈旧性口腔上颌窦瘘,10例为上颌磨牙松动或残冠,牙根突入上颌窦腔,并发上颌窦炎,术中唇龈沟入路清理上颌窦病变,拔除患牙,用带蒂肌肉瓣一期修复口腔上颌窦瘘。结果 15例患者中成功14例,失败1例,失败患者为20年前因鼻咽癌行放射治疗患者,出现放射性骨坏死,术后10天瘘口再次裂开,饮水自瘘口呛入鼻腔。结论唇龈沟带蒂肌肉瓣修复口腔上颌窦瘘,可同时处理上颌窦病变,不影响缺牙区颊侧骨板高度,临床效果较好,值得推广。

Objective To evaluate the clinical effect of pedicled muscle flaps labiogingival groove approach in the repairing of oral-maxillary sinus fistula.Methods A retrospective analysis was made of 15 patients with oral-maxillary sinus fistula,which includes 9 males and 6 females,aged 25~56 years.Five patients were old maxillary sinus fistula after extraction of maxillary molars.Ten patients had loose or residual crown of maxillary molars with the roots protruding into maxillary sinus cavity causing maxillary sinusitis.During repairing operations,the lesions of maxillary sinus were cleared via Calwell Luc’s approach,the affected teeth were extracted,and the maxillary sinus fistula was repaired with pedicled muscle flaps in one stage.Results Among the 15 patients,only 1 suffered unsuccessful result.The reason for that is the patients underwent radiotherapy for nasopharyngeal carcinoma twenty years ago which resulted in osteonecrosis.Ten days after the operation,the fistula opened again,and water were choked into the nasal cavity from the fistula.Conclusions The pedicled muscular flaps through labiogingival groove approach can treat maxillary sinus fistula at the same time without affecting the buccal bone plate height in edentulous area.The clinical effect is good and it is worth popularizing.