资源描述：
《鼻内镜下犬齿窝径路治疗上颌窦病变》由会员上传分享，免费在线阅读，更多相关内容在工程资料-天天文库。
1、鼻内镜下犬齿窝径路治疗上颌窦病变【摘要】探讨一个损伤少，方便快捷且效果好的鼻内镜下的上颌窦手术方案治疗上颌窦病变。方法：2002年3月至今，设计在患侧唇龈沟第三齿上方做一纵形切口1l・5?cm,分离至犬齿窝骨质，用骨凿或电钻做l?cm左右的骨孔，清除此处的上颌窦黏膜，置入鼻内镜，检查上颌窦内的病变情况，如果为上颌窦黏膜下囊肿，去除囊壁，妥善止血；上颌窦自然窦口正常者，无须扩大窦口，在上颌窦内的创面上和犬齿窝骨窗处贴附止血纱布，缝合2针，也可以应用耳脑胶粘合。如果为上颌窦息肉，处理方法基本同上颌窦囊肿。如果为上颌窦曲菌病，就需要扩大上颌窦自然窦口11.5?
2、cm,鼻腔内可不必填塞，如需扩大自然窦口，可填塞膨胀海绵。结果：36例均一期愈合，鼻腔通畅，症状消失，经过4个月4年的随访观察，未见病变复发，仅2例有短暂的唇部麻木，78?d后康复。2例扩大自然窦口处有肉芽生长，经处理后肉芽消失。结论：本术式有视野清晰，处理病变方便，并发症少，不宜发生严重的反应，窦口引流自然，符合上颌窦黏膜的正常生理特占八、o【关键词】上颌窦外科手术犬齿窝[ABSTRACT]Objective:Operationinthemaxillarysinustendstoinjurethedebouchementofthenasolacrim
3、alcanalintheinferiornasalmeatusandthewallsofthefossaorbitalis.Wetriedtofindaprogramwiththeleastinjury,durationandthatwasthemostconvenience.Methods:FromMarch2002tothepresent，wedesignedanuprightcutof1to1.5cminthesidelabiogingivalgrooveofthei11sideabovethecaninetooth,separatedtotheb
4、oneincaninefossa,drilledaholeof1cmwithanosteotomeorelectrodri11,removedthelocalmucosa,insertedanendoscope,andinspectedthelesionsinside.Ifsubmucouscystswerefound,thecapsulewallwasremovedandproperhemostasiswasperformed;ifthemucosawasnormal,therewasnoneedtoenlargetheaperture,anabsor
5、bablehemostaticgauzewaslaidinthewoundsurfaceandthehole,andsuturedwith2stitches;oradheredwithbiologicalglue.Inpatientswithanantralpolyp,themanagementwasthesameasthecaseswithsumucosacyst.Inpatientswithaspergillosis,weenlargedtheaperturesto11.5?cm，didnotpackthenasalcavity,ifweenlarg
6、edtheapertures,wemaypackexpansivesponge.Thefacewasoppressedwithafourheadbelt,theplugwastakenoutafter48or72hoursaccordingtothepathogeneticcondition,andstitchesweretakenoutafter4or5days.Results：Primaryhealingwasfoundinall36cases,withanunobstructednasalcavityanddisappearanceofthesym
7、ptom.Norelapsewasfoundintheperiodoffourmonthstofouryearsoffollowup;only2casescomplainedabouttransientnumbnessintheupperlips.Al1patientsrecoveredafter78days.Granulationswerefoundintheenlargedaperturein2cases,andtheydisappearedaftertreatment.Conclusion:Thefeatureoftheoperationisthe
8、smalluprightcutinthelabiogingivalgrooves
