山东大学耳鼻喉眼学报 ›› 2024, Vol. 38 ›› Issue (2): 84-88.doi: 10.6040/j.issn.1673-3770.0.2022.382

• 论著 • 上一篇    下一篇

鼻内镜下经鼻开窗术治疗上颌骨囊肿9例并文献复习

刘家欣1,姜叶2,宋道亮2   

  1. 1. 滨州医学院, 山东 滨州 256603;
    2. 淄博市中心医院 鼻科, 山东 淄博 255000
  • 出版日期:2024-03-20 发布日期:2024-03-29
  • 通讯作者: 宋道亮. E-mail:songdaoliang1971@163.com

Endoscopic transnasal fenestration for maxillary bone cysts: a report of nine cases and a review of the literature

LIU Jiaxin1, JIANG Ye2, SONG Daoliang2   

  1. 1. BinZhou Medical University, Binzhou 256603, Shandong, China2. Nasal Department, ZiBo Central Hospital, Zibo 255000, Shandong, China
  • Online:2024-03-20 Published:2024-03-29

摘要: 目的 探讨鼻内镜下经鼻开窗术治疗上颌骨囊肿的可行性。 方法 回顾性分析9例上颌骨囊肿病例,其中成人8例、儿童1例,根据囊肿与上颌窦及鼻腔的位置关系,选择相应的手术路径在鼻内镜下经鼻行上颌骨囊肿开窗术,观察手术效果。并通过中国知网、万方医学网、外文医学信息资源检索平台检索国内外关于颌骨囊肿相关文献,进行数据总结。 结果 9例中1位1岁患者出现术后复发,其余患者均1次手术成功,术后随访6~24个月,囊腔引流通畅,囊腔均成上皮化改变。相关文献表明鼻内镜下经鼻上颌骨囊肿开窗术有以下优点:更具微创性、神经损伤小,有效改善患者生活质量。 结论 鼻内镜下经鼻开窗术治疗上颌骨囊肿具有临床应用价值,但对该术式的适应证及禁忌证有待进一步探讨。

关键词: 上颌骨, 颌骨囊肿, 鼻内镜, 开窗术, 相关学科

Abstract: Objective To investigate the feasibility of endoscopic transnasal fenestration in the treatment of maxillary bone cysts. Methods Nine patients with maxillary bone cysts, including eight adults and one child, were retrospectively analyzed. The corresponding surgical approach of endoscopic transnasal fenestration for maxillary bone cysts was selected based on the location of the cyst and the relationship between the cyst and the maxillary sinus and nasal cavity. The related literature on jaw cysts from China and abroad was retrieved through the China National Knowledge Infrastructure, Wanfang medical network, and foreign medical information resource retrieval platforms. Results Among the nine cases, only one 1-year-old patient had recurrence after surgery, while the other patients were successfully operated. The cyst cavity had unobstructed drainage and was epithelialized during a follow-up period of 6-24 months. The related literature showed that the transnasal endoscopic fenestration of maxillary bone cysts has the following advantages: it is highly minimally invasive, causing less nerve damage, and can effectively improve the quality of life of patients. It has become the first choice of treatment in rhinology. Conclusion Endoscopic transnasal fenestration for maxillary bone cysts has clinical application value; however, its indications and contraindications need to be further studied.

Key words: Maxillary bone, Jaw cyst, Nasal endoscopy, Fenestration, Related disciplines

中图分类号: 

  • R765.9
[1] Hahn HM, Lee YJ, Park DH. Huge radicular cyst of the maxilla treated with complete resection and immediate reconstruction by rib bone graft[J]. J Maxillofac Oral Surg, 2019, 18(3): 378-381. doi:10.1007/s12663-018-1125-0
[2] 郭骏, 黄怡, 费伟, 等. 颌骨囊肿开窗减压术与刮治术临床疗效评价及应用分析[J]. 口腔颌面外科杂志, 2018, 28(4): 219-224. doi:10.3969/j.issn.1005-4979.2018.04.008 GUO Jun, HUANG Yi, FEI Wei, et al. Clinical evaluation and application analysis of fenestration decompression and curettage for jaw cysts[J]. Journal of Oral and Maxillofacial Surgery, 2018, 28(4): 219-224. doi:10.3969/j.issn.1005-4979.2018.04.008
[3] 高鹏, 李军. 开窗减压术治疗颌骨囊肿的研究进展[J]. 全科口腔医学电子杂志, 2019, 6(13): 26. doi:10.16269/j.cnki.cn11-9337/r.2019.13.015 GAO Peng, LI Jun. Research progress of fenestration decompression for jaw cyst[J]. Electronic Journal of General Stomatology, 2019, 6(13): 26. doi:10.16269/j.cnki.cn11-9337/r.2019.13.015
[4] 李淑华, 曹发明, 许从平, 等. 开窗减压术与传统刮治术治疗颌骨囊肿的手术效果、生活质量和预后的对比研究[J]. 现代生物医学进展, 2020, 20(17): 3260-3263. doi:10.13241/j.cnki.pmb.2020.17.013 LI Shuhua, CAO Faming, XU Congping, et al. A comparative study on the operative effect, quality of life and prognosis of fenestration decompression and curettage in the treatment of jaw cyst[J]. Progress in Modern Biomedicine, 2020, 20(17): 3260-3263. doi:10.13241/j.cnki.pmb.2020.17.013
[5] 曾宾华, 陈家财, 罗艳荣, 等. 开窗减压术与颌骨囊肿刮治术治疗颌骨囊肿的疗效比较及对术后血清疼痛介质的影响[J]. 现代生物医学进展, 2022, 22(8): 1498-1501. doi:10.13241/j.cnki.pmb.2022.08.020 ZENG Binhua, CHEN Jiacai, LUO Yanrong, et al. Comparison between fenestration decompression and curettage of jaw cyst in the treatment of jaw cyst and its eeffect on postoperative serum pain mediators[J]. Progress in Modern Biomedicine, 2022, 22(8): 1498-1501. doi:10.13241/j.cnki.pmb.2022.08.020
[6] Li SH, Wang Y, Huang ZX, et al. Endoscope-assisted surgery in the treatment of dentigerous cyst involving the maxillary sinus - report of two cases[J]. Chin J Dent Res, 2020, 23(1): 71-76. doi:10.3290/j.cjdr.a44338
[7] Safadi A, Kleinman S, Gigi D, et al. Surgical management of odontogenic cysts involving the maxillary sinus- a retrospective study[J]. J Cranio Maxillofac Surg, 2020, 48(8): 800-807. doi:10.1016/j.jcms.2020.06.011
[8] 王磊, 袁英, 于学民, 等. 鼻内镜手术治疗上颌骨囊肿的临床分析[J]. 山东大学耳鼻喉眼学报, 2020, 34(6):31-35. doi:10.6040 /j.issn.1673-3770.0.2019.630 WANG Lei, YUAN Ying, YU Xuemin, et al. Endoscopy surgery for maxillary cysts: A clinical analysis[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(6):31-35. doi:10.6040 /j.issn.1673-3770.0.2019.630
[9] 陈新军, 李刚, 郝蕴, 等. 鼻内镜下经鼻造袋术治疗上颌骨囊肿[J]. 中国耳鼻咽喉头颈外科, 2021, 28(11): 705-707. doi:10.16066/j.1672-7002.2021.11.011 CHEN Xinjun, LI Gang, HAO Yun, et al. Treatment of maxillary cyst by marsupialization under transnasal endoscopy[J]. Chinese Archives of Otolaryngology-Head and Neck Surgery, 2021, 28(11): 705-707. doi:10.16066/j.1672-7002.2021.11.011
[10] 王春雨, 王永福, 张芬, 等. 鼻口腔相关外科学理念的建立与临床应用[J]. 中国医学文摘(耳鼻咽喉科学), 2018, 33(4): 303-305. doi:10.19617/j.issn1001-1307.2018.04.303 WANG Chunyu, WANG Yongfu, ZHANG Fen, et al. Concept establishment and clinical application of nasal and oral related surgery[J]. Chinese Medical Digest(Otorhinolaryngology), 2018, 33(4): 303-305. doi:10.19617/j.issn1001-1307.2018.04.303
[11] 张林娜, 王恩群. 485例颌骨囊肿临床病例分析[J]. 名医, 2021(1): 114-115 ZHANG Linna, WANG Enqun. Clinical analysis of 485 cases of jaw cyst[J]. Renowned Doctor, 2021(1): 114-115
[12] Rivi??塂 M, Roi CI, Roi A, et al. Contribution of the cyto-histopathological diagnosis and ultrastructural parameters to the evaluation of maxillary cysts- a 10-year multidisciplinary approach[J]. Rom J Morphol Embryol, 2020, 61(4): 1279-1286. doi:10.47162/RJME.61.4.28
[13] 齐国荣, 刘乐, 韩秋宏, 等. 鼻内镜开窗术与传统手术治疗上颌骨囊肿的临床观察及对上唇麻木率、炎症因子水平的影响[J]. 武警后勤学院学报(医学版), 2019, 28(5): 26-29. doi:10.16548/j.2095-3720.2019.05.006 QI Guorong, LIU Le, HAN Qiuhong, et al. Clinical observation of endoscopic fenestration and traditional surgery in the treatment of maxillary cysts and effect on the rate of upper lip numbness and levels of inflammatory factors[J]. Journal of Logistics University of PAP(Medical Sciences), 2019, 28(5): 26-29. doi:10.16548/j.2095-3720.2019.05.006
[14] 胡爽, 李春梅, 张帅源, 等. 口腔修复膜和β-磷酸三钙治疗颌骨囊肿术后骨缺损的临床价值[J]. 华西口腔医学杂志, 2020, 38(5): 541-545. doi:10.7518/hxkq.2020.05.012 HU Shuang, LI Chunmei, ZHANG Shuaiyuan, et al. Clinical value of oral repair membrane and β-tricalcium phosphate in the treatment of the postoperative bone defect of jaw cyst[J]. West China Journal of Stomatology, 2020, 38(5): 541-545. doi:10.7518/hxkq.2020.05.012
[15] 樊星, 白振西, 肖霞, 等. 同种异体松质骨修复颌骨囊肿术后骨缺损[J]. 生物骨科材料与临床研究, 2018, 15(6): 38-40. doi:10.3969/j.issn.1672-5972.2018.06.010 FAN Xing, BAI Zhenxi, XIAO Xia, et al. The repairing of bone defect after the operation of jaw cyst with allogeneic cancellous bone[J]. Orthopaedic Biomechanics Materials and Clinical Study, 2018, 15(6): 38-40. doi:10.3969/j.issn.1672-5972.2018.06.010
[16] 林后学, 周倩雯, 黄静, 等. 医用胶原蛋白海绵促进小型颌骨囊肿术后成骨的临床对比研究[J]. 实用口腔医学杂志, 2021, 37(4): 521-524. doi:10.3969/j.issn.1001-3733.2021.04.017 LIN Houxue, ZHOU Qianwen, HUANG Jing, et al. Clinical study on medical collagen sponge for the promotion of osteogenesis after removal of jaw cysts[J]. Journal of Practical Stomatology, 2021, 37(4): 521-524. doi:10.3969/j.issn.1001-3733.2021.04.017
[17] 金岚, 赵文妍, 阮妍, 等. 开窗减压术治疗颌骨囊肿的临床价值[J]. 中华全科医学, 2021, 19(11): 1851-1854. doi:10.16766/j.cnki.issn.1674-4152.002183 JIN Lan, ZHAO Wenyan, RUAN Yan, et al. Clinical value of fenestration decompression in the treatment of jaw cysts[J]. Chinese Journal of General Practice, 2021, 19(11): 1851-1854. doi:10.16766/j.cnki.issn.1674-4152.002183
[18] 王亮, 任镟伊, 应凯. 开窗术保留颌骨囊肿非病灶牙的临床分析[J]. 口腔颌面外科杂志, 2021, 31(3): 177-179. doi:10.3969/j.issn.1005-4979.2021.03.009 WANG Liang, REN Xuanyi, YING Kai. Clinical analysis on preserving non-focused teeth of jaw cysts after fenestration management[J]. Journal of Oral and Maxillofacial Surgery, 2021, 31(3): 177-179. doi:10.3969/j.issn.1005-4979.2021.03.009
[19] 赵怡芳, 刘冰. 颌骨囊性病受累牙处理的现代策略[J]. 口腔颌面外科杂志, 2019, 29(1): 1-10. doi: 10.3969/j.issn.1005-4979.2019.01.001 ZHAO Yifang, LIU Bing. Contemporary strategies for managing tooth/teeth associated with cystic lesions of the jaws[J]. Journal of Oral and Maxillofacial Surgery, 2019, 29(1): 1-10. doi: 10.3969/j.issn.1005-4979.2019.01.001
[20] Pittl TL, Meier M, Hakl P, et al. Long-term observation of a large keratocystic odontogenic tumour of the mandible treated by a single enucleation procedure: a case report and literature review[J]. Int J Surg Case Rep, 2017, 34: 119-122. doi:10.1016/j.ijscr.2017.03.033
[21] 王英斌, 吴虹, 吴桂卿, 等. 鼻内镜下鼻内开窗术治疗上颌骨囊肿的临床观察[J]. 中国内镜杂志, 2017, 23(5): 88-92. doi:10.3969/j.issn.1007-1989.2017.05.019 WANG Yingbin, WU Hong, WU Guiqing, et al. Clinical observation of maxillary cyst with endoscopic marsupialization in nasal[J]. China Journal of Endoscopy, 2017, 23(5): 88-92. doi:10.3969/j.issn.1007-1989.2017.05.019
[22] 廖红明, 何本超, 郑志刚. 鼻内开窗术治疗巨大上颌骨囊肿的临床观察[J]. 中国耳鼻咽喉颅底外科杂志, 2020, 26(2): 188-190. doi:10.11798/j.issn.1007-1520.202002018 LIAO Hongming, HE Benchao, ZHENG Zhigang. Clinical observation on the treatment of giant maxillary bone cysts with intranasal fenestration[J]. Chinese Journal of Otorhinolaryngology-Skull Base Surgery, 2020, 26(2): 188-190. doi:10.11798/j.issn.1007-1520.202002018
[23] 冯昕, 徐丽娜, 陈文荟, 等. 改良泪前隐窝入路上颌骨囊肿开放术[J]. 中华耳鼻咽喉头颈外科杂志, 2021, 56(8): 863-866. doi:10.3760/cma.j.cn115330-20201118-00875 FENG Xin, XU Lina, CHEN Wenhui, et al. Surgical treatment of maxillary bone cyst though modified endoscopic prelacrimal recess approach[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2021, 56(8): 863-866. doi:10.3760/cma.j.cn115330-20201118-00875
[24] 陶谦, 兰天俊. 开窗治疗颌骨囊性病变的临床思考与循证[J]. 口腔疾病防治, 2018, 26(12): 759-765. doi:10.12016/j.issn.2096-1456.2018.12.002 TAO Qian, LAN Tianjun. Clinical thinking and evidence-based for decompression of cystic lesions in the jaw bone[J]. Journal of Dental Prevention & Treatment, 2018, 26(12): 759-765. doi:10.12016/j.issn.2096-1456.2018.12.002
[25] 范晨旭, 张凯, 陈永锋, 等. CBCT评价开窗减压术治疗青少年颌骨囊肿的临床疗效[J]. 齐齐哈尔医学院学报, 2019, 40(1): 48-52. doi:10.3969/j.issn.1002-1256.2019.01.023 FAN Chenxu, ZHANG Kai, CHEN Yongfeng, et al. Evaluation on the clinical effect of decompression in the treatment of juvenile jaw bone cyst by using CBCT[J]. Journal of Qiqihar Medical University, 2019, 40(1): 48-52. doi:10.3969/j.issn.1002-1256.2019.01.023
[26] 孙宁宁, 郭永峰, 周青, 等. 改良引流式开窗术治疗儿童及青少年大型颌骨囊性病变的临床研究[C] //第十四次中国口腔颌面外科学术会议论文汇编. 重庆, 2018: 518.
[27] 郭骏, 黄怡, 费伟, 等. 颌骨囊肿开窗减压术与刮治术临床疗效评价及应用分析[J]. 口腔颌面外科杂志, 2018, 28(4): 219-224. doi:10.3969/j.issn.1005-4979.2018.04.008 GUO Jun, HUANG Yi, FEI Wei, et al. Clinical evaluation and application analysis of fenestration decompression and curettage for jaw cysts[J]. Journal of Oral and Maxillofacial Surgery, 2018, 28(4): 219-224. doi:10.3969/j.issn.1005-4979.2018.04.008
[1] 李帅,黄春燕,常明章. 鼻内镜下鼻中隔软骨尾端偏曲矫正术的临床效果分析[J]. 山东大学耳鼻喉眼学报, 2025, 39(6): 65-70.
[2] 王再兴,唐志元,李定波,石照辉,曾宪海,张秋航. 鼻咽癌放疗后肿瘤复发及颅底骨坏死引起颈内动脉破裂的治疗方案[J]. 山东大学耳鼻喉眼学报, 2025, 39(4): 49-58.
[3] 姜知临,朱瑞楷,邱前辉. 基于影像学对咽旁颈内动脉走行的观察与分析[J]. 山东大学耳鼻喉眼学报, 2025, 39(4): 69-76.
[4] 郭荣昌,刘晴航,王洪增,孙树军. 巨大鼻眼贯通、颅底嵌顿异物损伤1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2025, 39(4): 135-141.
[5] 黄爱萍,王娟,王丽,耿江桥,王亚芳,温鑫. 儿童原发扁桃体Burkitt淋巴瘤累及上颌骨和肺1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2025, 39(3): 148-152.
[6] 李晓宇,王彬晨,徐大朋,王艳华,杜平功,张庆泉. 三维建模配准分析经口与经鼻开窗治疗上颌骨囊肿三维形态变化[J]. 山东大学耳鼻喉眼学报, 2025, 39(2): 72-78.
[7] 孙乐,张云云,刘浩,叶京英,吴彦桥. 鼻内镜辅助下经口鼻联合入路腭部巨大多形性腺瘤切除术1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2025, 39(1): 117-122.
[8] 石忠刚,蔡晓岚,李学忠,张立强,冯昕. 上颌骨囊肿并内翻性乳头状瘤1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2025, 39(1): 123-129.
[9] 侯静,房高丽,周兵. 功能性鼻内镜手术后鼻黏膜囊泡的形成机制及囊液成分分析:一项组织生化学研究[J]. 山东大学耳鼻喉眼学报, 2024, 38(5): 1-5.
[10] 郑露,程杰,欧阳虹,池花明,杜敬东. A型血友病致难治性鼻出血1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2024, 38(5): 86-90.
[11] 李美辰,陈海玲,李阳,马登殿. 下鼻甲黏液囊肿1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2024, 38(5): 91-94.
[12] 后婕,刘丁丁,王涵东,徐峥嵘,钱晓云,高下,俞晨杰. 鼻内镜下经泪前隐窝-翼突入路上咽旁间隙病变手术[J]. 山东大学耳鼻喉眼学报, 2024, 38(4): 28-35.
[13] 陈兴雪,张广玲,武天义,王卫卫,孙占伟,李世超,王广科. 抗IL-4Rα单克隆抗体与鼻内镜手术治疗嗜酸性粒细胞型慢性鼻窦炎伴鼻息肉的疗效分析[J]. 山东大学耳鼻喉眼学报, 2024, 38(4): 43-54.
[14] 袁玥,庞文会,陈敏,付圣尧,于龙刚,孙钰博,李玲玲. 毛霉菌性鼻窦炎25例临床特征分析[J]. 山东大学耳鼻喉眼学报, 2024, 38(4): 102-107.
[15] 李红金,王剑,来育斌,许敏,薛涛,陈福权,查定军,陈晓栋. 不同术式治疗上颌骨囊肿的疗效评价[J]. 山东大学耳鼻喉眼学报, 2024, 38(3): 33-37.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!