轮廓化后半周膜鼻泪管在治疗上颌窦良性病变中的意义
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南京大学医学院附属鼓楼医院耳鼻咽喉头颈外科,江苏省医学重点学科

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国家自然科学基金面上项目(82071044)。江苏省科教强卫工程江苏省重点学科项目(ZDXKB2016015)


Significance of contoured posterior semiperitoneal nasolacrimal duct in the treatment of benign maxillary sinus lesions
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    []:目的:探讨轮廓化后半周膜鼻泪管在治疗上颌窦病变的临床应用效果以及手术方法和适应证。方法:30例上颌窦良性病变患者均行鼻科常规术前检查及鼻窦影像学检查。患者均采用轮廓化后半周膜鼻泪管手术,该术式通过去除鼻泪管骨管后半周骨质及依附其上的黏膜组织,从而扩大上颌窦自然开口,保留鼻泪管膜部,进入窦腔,去除病变。结果:所有患者术中彻底清除病变,术中完整保护鼻泪管膜部,术后恢复良好,窦腔上皮化良好,病变均无复发,无鼻周局部麻木、鼻翼塌陷、溢泪等并发症。结论:轮廓化后半周膜鼻泪管手术通过保留鼻泪管膜部,可扩大手术视野,增大手术操作空间,从而减小手术损伤,避免并发症,对于处理上颌窦的良性病变有巨大优势,并可最大限度保留鼻腔、上颌窦的生理功能,防止窦口狭窄,是值得推广的手术方式。

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    [Abstract]: Objective: To explore the clinical application effect, surgical methods and indications of benign maxillary sinus disease after contouring of the semi-peripheral membrane of nasolacrimal duct. Methods: Thirty patients with benign maxillary sinus disease underwent routine preoperative rhinology examination and sinus imaging examination. All patients underwent endoscopy to enlarge the natural opening of the maxillary sinus. This operation removed the bone in the second half of the nasolacrimal duct and the mucosal tissue attached to it, thereby expanding the natural opening of the maxillary sinus and retaining the nasolacrimal duct. Enter the sinus cavity and remove the lesion. Results: All patients recovered well, the maxillary sinus function was normal, the epithelialization of the sinus cavity was good, no recurrence of the lesions, no local numbness around the nose, nose collapse, tears and other complications. CONCLUSION: Contoured nasolacrimal duct surgery can preserve the nasolacrimal duct membrane by retaining the nasolacrimal duct, which can expand the surgical field and increase the operating space, thereby reducing surgical damage and avoiding complications. It has great advantages for the treatment of benign maxillary sinus disease. It can preserve the physiological functions of the nasal cavity and maxillary sinus to the maximum extent and prevent sinus stenosis. It is a surgical method worth promoting.

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  • 收稿日期:2022-01-16
  • 最后修改日期:2022-03-19
  • 录用日期:2022-03-25
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