鼻内镜下摘除上颌窦囊肿3种术式的探讨

目的：探讨鼻内镜下摘除上颌窦囊肿的3种手术径路。方法：3种手术径路分别是(1)扩大上颌窦自然开口径路；(2)下鼻道开窗径路；(3)上颌窦前壁带蒂骨瓣翻揭径路，分别为20例、5例和5例。结果：30例术后随访均6个月以上，经鼻窦CT复查，上颌窦内黏膜光滑、窦内无异物及积液，囊肿无复发，全部痊愈。结论：3种手术径路与柯一陆术式相比具有微创，患者出血少，痛苦小，康复快等特点。但这3种术式也各有优缺点临床上需酌情选用。

Three approaches of removal of the maxillary sinus cyst with the nasal sinus endoscope

Objective:To explore the best approach of removal of the maxillary sinus cyst with the nasal sinus endoscope.Methods:Three approaches were adopted to 30 cases of maxillary sinus cyst,(1)enlarged natural aperture to remove the cyst;(2)the approach of windowing of the inferior nasal meatus;(3)the approach of overturn of the bone flap of anterior wall of maxillary sinus with pedicel.Result: By more than six months follow-up and re-examination by CT, none recurred and the mucous membrane of the maxillary sinus was smooth, without foreign body and accumulated fluid in the maxillary sinus. Conclusion:Compared with the traditional method(Caldwell-Luc operation),the three approaches of removal of the maxillary sinus cyst with the nasal sinus endoscope, are with small trauma, a little bleeding, small distress and quick restoration. But the three approaches also have merits and defects, they should be adopted based on the condition of the case.