鼻窦镜检查及上颌窦腔粘膜超微结构观察

Sinuscopy and Ultrastructural Observation of Maxillary Sinus Mucosa

对50例上颌窦手术后半年至5年随访,随访结果30例症状消失,各鼻道通畅,无脓性分泌物。20例术后仍有症状者行鼻镜与鼻窦镜检查,部分病例并行电镜检查。其中,刮除窦腔全部粘膜8例,刮除部分粘膜12例。检查结果提示,术后再生粘膜的生理功能与术中是否损伤自然孔周围粘膜有关,远期效果与自然孔和对孔的通畅与否有宜接关系。良性肿瘤术后有结构完善的纤毛粘膜上皮生长。而恶性肿瘤手术后再生粘膜只见不典型粘膜上皮细胞,无纤毛上皮细胞。

Follow-up studies were carried on in 50 patients for half to five years aftermaxillary surgery, rhinoscopy and sinuscopy and electromicroscopy were performedin part of them. The results revealed disappearance of symptoms with patent nasalmeatuses devoid of purulent discharge in 30 cases. Of the other 20 patients withpersistent symptoms 8 had sinusal mucosa totally curetted and partly removed in 12.It was suggested that the physiological function of postoperative regenerative mucosawas related to the presence or absence of mucosal damage around the ostium, and thatthe long-term effect was directly related to the patencies of the ostium and thefenestra. Structurally intact ciliated epithelium could be seen in patients after sur-gery for benign tumors, while in those with malignancies the postoperative regener-ative mucosa showed only atypical mucosal epithelelium but not ciliated epithelialcells.