下鼻甲-鼻泪管复合瓣翻转术入路切除上颌窦内翻性乳头状瘤

The inferior turbinate-nasolacrimal duct complex flap flip approach was used to rescind the maxillary sinus inverted papilloma

摘要:

【】目的:介绍翻转下鼻甲-鼻泪管复合瓣入路的鼻腔外侧壁切除的手术方式。方法:本研究纳入了11例2020年6月至2024年1月期间诊断为上颌窦内翻性乳头状瘤(maxillary sinonasal Inverted papilloma,MSIP)且肿瘤基底部位较为隐蔽的患者,所有患者均通过翻转下鼻甲-鼻泪管复合瓣的泪前入路手术方式切除肿瘤。手术中探查肿瘤基底部后,确定和切开下鼻甲-鼻泪管复合瓣的前、后、下界,暴露和游离膜性鼻泪管,最后达到翻转下鼻甲-鼻泪管复合瓣的目的。扩大手术视野后,完整切除肿瘤并对肿瘤基底部附着骨质进行灼烧,最后复位和简单缝合下鼻甲-鼻泪管复合瓣。结果:使用该技术可以针对不同的泪前隐窝气化类型,做到等同于鼻腔外侧壁切除的术野及显露,同时上颌窦的前壁、齿槽隐窝、颧隐窝的暴露率均可以达到100%。在MSIP患者中,平均随访9个月无肿瘤复发。所有患者均保留了下鼻甲前段及膜性鼻泪管。术后均无明显溢泪症状且无明显鼻通气功能异常。

关键词:上颌窦;内翻性乳头状瘤;下鼻甲;鼻泪管

Abstract:

Objective: This paper introduces the surgical method of lateral nasal wall resection by reversing the inferior turbinate-nasolacrimal duct complex flap. Method: This study included 11 patients diagnosed with maxillary sinonasal Inverted papilloma (MSIP) from June 2020 to January 2024 with concealed tumor base. In all patients, the tumors were resected by the anterior lacrimal approach of reversing the inferior turbinate-nasolacrimal duct complex flap. After exploring the base of the tumor, the anterior, posterior and lower boundaries of the inferior turbinate-nasolacrimal duct were identified and cut, exposing and freeing the membranous nasolacrimal duct to accomplish the aim of reversing the inferior turbinate-nasolacrimal duct complex valve. With an expansion of the surgical field, the tumor was completely resected and the bone attached to the tumor base was cauterized. Finally, the inferior turbinate-nasolacrimal duct complex flap was repositioned and simply sutured. Results: This technique can be used for

Key words:maxillary sinus; inverted papilloma;inferior turbinate; nasolacrimal duct.