鼻内镜下上颌窦良性病变的手术入路

doi:10.6040/j.issn.1673-3770.0.2015.096

摘要/Abstract

摘要： 上颌窦的良性病变主要包括炎性病变或良性肿瘤性病变, 在鼻内镜技术出现之前, 治疗方式主要为Caldwell-Luc术式, 即经典上颌窦根治术。随着鼻内镜技术的发展应用, 一些上颌窦良性病变手术可经下鼻道或中鼻道完成, 临床上已经基本上代替了Caldwell-Luc术式, 一些开放性的手术也在鼻内镜辅助下有所改进。鼻内镜技术优势在于有良好的手术视野及对患者所造成的创伤小, 可以最大程度的保留下鼻甲、鼻泪管等生理结构组织。在鼻内镜技术日益成熟的今天, 许多术式在不断的发展创新, 该文通过文献复习, 对鼻内镜下上颌窦病变的手术入路进行综述。

关键词: 上颌窦, 良性病变, 鼻内镜外科手术, 文献综述

Abstract: The benign lesions of maxillary sinus mainly include inflammatory lesions and benign tumorous lesions. Caldwell-Luc operation, the radical maxillary sinusotomy, was the major treatment for the benign lesions of maxillary sinus before the nasal endoscopic surgery was used. With the development of nasal endoscopy technology, basically replaced Caldwell-Luc operation, some operation for the benign lesions of maxillary sinus can be performed by endoscopy via the middle or inferior meatus approach. And open surgery with nasal endoscopy-assistedhas been improved as well. Nasal endoscopic surgery has the advantages of well surgical field, small trauma and keeping the organizational structure of inferior turbinate and nasolacrimal duct. With nasal endoscopic surgery becoming more mature, operation continues to develop with innovation. This paper will review the surgical approachs of nasal endoscopic surgery for maxillary sinus lesions.

Key words: Maxillary sinus, Benign lesion, Endoscopic surgical procedures, operative, Literature review

中图分类号:

R765.9

王晓勇, 宋西成. 鼻内镜下上颌窦良性病变的手术入路[J]. 山东大学耳鼻喉眼学报, 2015, 29(3): 90-92.

WANG Xiaoyong, SONG Xicheng. Endoscopic surgery for surgical approache of benign lesion of maxillary sinus[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2015, 29(3): 90-92.

参考文献

[1] Matheny K E, Duncavage J A. Contemporary indications for the Caldwell-Luc procedure[J]. Curr Opin Otolaryngol Head Neck Surg, 2003, 11(1):23-26.
[2] 黄选兆, 汪吉宝, 孔维佳. 实用耳鼻咽喉头颈外科学[M]. 2版. 北京:人民卫生出版社, 2008:195-196.
[3] Lane A P, Bolger W E. Endoscopic management of inverted papilloma[J]. Curr Opin Otolaryngol Head Neck Surg, 2006, 14(1):14-18.
[4] 孙树岩, 邱林莉, 于平. 上颌窦口解剖与中鼻道上颌窦开窗术[J]. 中华耳鼻咽喉科杂志, 1995, 30(5):295-298.SUN Shuyan, QIU Linli, YU Ping. The anatony of the maxillary ostium and the middle meatus atrostomy[J]. Chinese Journal of Otorhinolaryngology, 1995, 30(5):295-298.
[5] Kirihene R K, Rees G, Wormald P J. The influence of the size of the maxillary sinus ostium on the nasal and sinus nitric oxide levels[J]. Am J Rhinol, 2002, 16(5):261-264.
[6] Oh C K, Miman M C, Duncavage J A. Current value of nasal nitric oxide measurement in rhinology[J]. Curr Opin Otolaryngol Head Neck Surg, 2004, 12(1):30-33.
[7] 许成利, 左可军, 许庚. 上颌窦自然开口开放方式对上颌窦纤毛传输途径的影响[J]. 中华耳鼻咽喉头颈外科杂志, 2008, 43(4):259-262.XU Chengli, ZUO Kejun, XU Geng. Impact of draining mode of enlarged maxillary ostium on mucociliary transportation system[J]. Chin J Otorhinolaryngol Head Neck Surg, 2008, 43(4):259-262.
[8] Hosemann W, Scotti O, Bentzien S. Evaluation of telescopes and forceps for endoscopic transnasal surgery on the maxillary sinus[J]. Am J Rhinol, 2003, 17(5):311-316.
[9] Barzilai G, Greenbery E, Uri N. Indications for the Galdwell-Luc approach in the endoscopic era[J]. Otolaryngol Head Neck Surg, 2005, 132(2):219-220.
[10] 王春红, 李永华, 刘丕楠, 等. 鼻内镜手术治疗上颌窦良性占位性病变[J]. 中国耳鼻咽喉颅底外科杂志, 2009, 15(4):279-283.WANG Chunhong, LI Yonghua, LIU Pi'nan, et al. Endoscopic surgery for benign occupying lesions of maxillary sinus[J]. Chin J Otorhinolaryngol Skull Base Surg, 2009, 15(4):279-283.
[11] 宋西成, 孙岩, 张华, 等. 鼻内镜下鼻泪管前径路和后径路切除上颌窦良性病变[J]. 中华耳鼻咽喉头颈外科杂志, 2011, 46(10):818-824.SONG Xicheng, SUN Yan, ZHANG Hua, et al. Endoscopic maxillary sinus surgery through anterior or posterior nasolacrimal duct approach[J]. Chin J Otorhinolaryngol Head Neck Surg, 2011, 46(10):818-824.
[12] 宋西成, 王强, 张华, 等. 下鼻甲翻转在真菌性上颌窦炎鼻内镜手术中的应用[J]. 山东大学耳鼻喉眼学报, 2007, 21(5):433-435.SONG Xicheng, WANG Qiang, ZHANG Hua, et al. Inferior nasal concha flipping for mycotic maxillary sinusitis under a rhino-endoscope[J]. J Otolaryngol Ophthalmol Shandong Univ, 2007, 21(5):433-435.
[13] 陈秀梅, 宋西成. 鼻内镜下下鼻甲翻转入路治疗上颌窦内翻性乳头状瘤[J]. 山东大学耳鼻喉眼学报, 2013, 27(2):37-39.CHEN Xiumei, SONG Xicheng. Inferior nasal concha flipping for treatment of inverted papilloma of the maxillary sinus by endoscopy[J]. J Otolaryngol Ophthalmol Shandong Univ, 2013, 27(2):37-39.
[14] 周兵, 韩德民, 崔顺九, 等. 鼻内镜下鼻腔外侧壁切开上颌窦手术[J]. 中华耳鼻咽喉头颈外科杂志, 2007, 42(10):743-748. ZHOU Bing, HAN Demin, CUI Shunjiu, et al. Endoscopic nasal lateral wall dissection approach to maxillary sinus[J]. Chin J Otorhinolaryngol Head Neck Surg, 2007, 42(10):743-748.
[15] 刘澍, 薛少飞, 赵玉琴, 等. 鼻内镜下泪前隐窝入路治疗上颌窦良性病变[J]. 中国耳鼻咽喉颅底外科杂志, 2012, 18(5):370-373. LIU Shu, XUE Shaofei, ZHAO Yuqin, et al. Endoscpic resection of begin lesions in maxillary sinus via anterior nasolacrimal recess approach[J]. Chin J Otorhinolaryngol Skull Base Surg, 2012, 18(5):370-373.
[16] 周兵, 黄谦, 崔顺九, 等. 内镜下经鼻泪前隐窝入路切除翼腭窝及颞下窝神经鞘瘤[J]. 中华耳鼻咽喉头颈外科杂志, 2013, 48(10):802-806. ZHOU Bing, HUANG Qian, CUI Shunjiu, et al. Removal of Schwannoma in the pterygopalatine and infratemperal fossa via endoscopic prelacrimal recess approach[J]. Chin J Otorhinolaryngol Head Neck Surg, 2013, 48(10):802-806.
[17] 张庆泉, 李新民, 王强, 等. 鼻内镜下犬齿窝径路治疗上颌窦病变[J]. 山东大学耳鼻喉眼学报, 2007, 21(1):38-39. ZHANG Qingquan, LI Xinmin, WANG Qiang, et al. Some experience of the endoscopic treatment of maxillary sinus lesion with the canine tooth fossa approach[J]. J Otolaryngol Ophthalmol Shandong Univ, 2007, 21(1):38-39.

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