开窗减压联合阻塞器在青少年颌骨囊肿治疗中的应用研究

目的:评价开窗减压术联合阻塞器治疗青少年颌骨囊肿的疗效。方法:14例7~16岁的青少年颌骨囊肿病例,行囊肿上方乳牙拔除或薄弱骨壁开窗,根据牙列特点和开窗位置制作个性化阻塞器并进行间隙保持,观察囊肿愈合、恒牙萌出及牙根发育情况。结果:术后6~12月囊腔全部消失,X线检查骨质破坏区基本消失。部分挤压移位的恒牙胚能够回位并萌出,患者能够很好配合和耐受。结论:涉及恒牙胚或未发育完成恒牙的青少年颌骨囊肿实施开窗减压术,是一种能够尽量保留病变区恒牙和去除囊肿的有效方法,可根据不同情况制作个性化阻塞器,囊肿关闭后可以适时正畸治疗恢复牙列形态。     

开窗减压术治疗下颌骨大型囊肿28例临床疗效分析

目的探讨开窗减压术对下颌骨大型囊肿的治疗效果。方法对28例下颌骨大型囊肿进行开窗减压术,引流出嶷液,使囊腔与口腔相通呈开窗状态,碘仿纱条填塞,1周后佩戴塞制器,定期冲洗囊腔,并对治疗效果进行跟踪随访。结果24例囊肿基本消失,4例囊肿行Ⅱ期手术,28例均未出现神经及邻近重要结构损伤症状,倾斜移位的牙长轴逐渐纠正;1例角化囊肿复发,行F颌骨方块切除术。结论开窗减压术是一种治疗下颌骨大型囊肿简单、创伤小及效果确实的治疗方法。     

开窗减压术治疗颌骨囊肿效果观察

目的观察开窗减压术治疗颌骨囊肿的临床价值。方法对32例颌骨囊肿实施开窗减压术治疗,缩小囊肿体积后,再根据囊肿情况必要时行II期手术切除囊肿。结果 32例患者经口内开窗减压治疗后均获随访1~2 a。30例术后6~12个月内囊腔明显变小并逐渐消失完全愈合,周围骨壁均见修复性增厚,颌骨形态完全修复。2例囊肿变化不明显者(角化囊肿)在全麻下行根治性刮除囊性病变,术后严密缝合切口,切口愈合良好。至今均未出现复发病例。结论开窗减压术治疗颌骨囊肿,创伤小,可明显缩小囊肿体积或促进囊肿消失,有效改善患者颌骨膨隆畸形,且并发症少,安全性高。     

开窗减压联合二期刮治术治疗下颌骨大型牙源性角化囊性瘤的临床观察

目的：评价开窗减压联合二期刮治术治疗下颌骨大型牙源性角化囊性瘤的临床效果。方法：选取1999-2013年收治11例下颌骨大型角化囊性瘤,先采用开窗减压术,二期采用刮治、电刀烧灼及机械磨削等方法进行治疗。结果：经2～5年随访观察,11例患者术后恢复良好,囊腔逐渐被新生骨完全替代,仅在开窗部位有少量骨质缺损。结论：开窗减压结合二期刮治术简单实用,并发症少,是根治下颌骨大型牙源性角化囊性瘤的有效方法。     

开窗负压引流术在下颌骨囊性病变治疗中的应用

目的：通过开窗减压加负压引流术治疗下颌骨囊性病变,并与传统手术治疗、单纯开窗术治疗方法相比较,探讨下颌骨囊肿治疗中保存颌骨功能及颌面外形的较佳治疗方法。方法：回顾采用开窗负压引流术治疗下颌骨囊性病变病例32例,平均负压引流18个月,通过摄X片及CT观察术后病灶变化,评价临床治疗效果。结果：术后病理诊断角化囊肿14例,造釉细胞瘤12例,含牙囊肿6例,30例术后囊腔有明显缩小,2例无变化。结论：开窗减压加负压引流术是治疗颌骨囊性病变的有效方法,能够消除病变引起骨膨隆破坏所致的颌面畸形。     

开窗引流术治疗牙源性颌骨囊肿的效果研究

目的 探讨开窗引流术治疗牙源性颌骨囊肿的手术疗效及对预后的影响。方法 选取2020年1月至2021年12月在杭州市临平区第一人民医院收治的牙源性颌骨囊肿患者70例纳入研究,采用随机数字表法分为两组,均为35例,对照组给予传统完整刮治术治疗,观察组行开窗引流术,术后随访3个月,定期复诊,检查其囊腔变化情况。比较两组手术指标;术后3个月囊腔体积减少量、面积减少量、骨密度;术后并发症及疾病复发情况。结果 观察组手术时间、术中出血量低于对照组,囊腔体积减少量、面积减少量、骨密度值均高于对照组,并发症发生率、复发率低于对照组（P<0.05）。结论 与传统完整刮治术比较,开窗引流术具有更好的治疗效果,可有效减少手术造成的机体创伤,囊腔恢复效果好,并发症发生率低,再次发病率低,可促进机体快速恢复。     

开窗减压术在治疗颌骨囊肿中的应用及术后感染的预防

目的:探讨开窗减压术在治疗颌骨囊肿中的效果,并研究其术后感染的预防措施,从而为临床提供借鉴。方法:选取我院2009年6月～2011年6月收治的颌骨囊肿患者20例,对其采用开窗减压术予以治疗,观察术后疗效并且做好防感染工作。同时收集其临床资料,并对其结果进行回顾性分析。结果:20例患者中有17例患者治愈,3例患者出现好转。所有患者半年后复诊发现囊腔体积与治疗前相比有明显缩小,并且无1例出现面部外形损坏。结论:开窗减压术能够保证减少患者的创伤,使牙列得以维护,保持了颌骨的连续性,最大程度地保护了颌骨的形态及功能。在治疗颌骨囊肿的问题上,开窗减压术可以缩小囊腔,恢复颌骨外形,值得推广。     

医用硫酸钙OsteoSet修复颌骨缺损的疗效评价

目的评价医用硫酸钙OsteoSet骨移植替代物在颌骨囊性病变切除后骨缺损治疗中的效果。方法 2009年12月-2010年5月,收治15例颌骨囊性病变患者。其中男9例,女6例;年龄15～75岁,平均36.6岁。患者术前均摄颌骨全景断层片(orthopantomography,OPT)测量囊肿大小,范围为1.5 cm×1.5 cm～8.0 cm×3.0 cm。均采用囊肿刮治术加OsteoSet骨移植替代物移植术进行治疗,术中囊肿切除后骨缺损范围为1.5 cm×1.5 cm×1.5 cm～8.0 cm×3.0 cm×3.0 cm,OsteoSet骨移植替代物植入量为2～15 mL。通过影像学方法评估OsteoSet骨移植替代物的成骨效果。结果术后病理检查提示:根尖周囊肿7例、牙源性角化囊肿5例、含牙囊肿3例。15例均获随访,随访时间6～12个月。13例患者切口Ⅰ期愈合;2例术后引流时间延长,分别为5 d和7 d,经加压包扎处理后切口愈合良好。1例术后1个月复查出现肿胀,无感染症状;无1例出现术后感染和排斥反应。所有患者术后1 d均行X线检查,见材料将骨缺损充填良好;术后1个月颌骨OPT复查发现植入的OsteoSet颗粒吸收近半;术后3个月植入的OsteoSet颗粒全部吸收,原囊腔低密度影面积明显变小,囊腔内高密度影增加明显,囊腔边界模糊;术后6个月原囊腔内影像密度与正常骨组织密度差别不明显,囊腔边界消失,新骨基本充满缺损区。结论医用硫酸钙OsteoSet骨移植替代物是一种理想的骨缺损充填材料。     

经腹腔镜去顶开窗术治疗单纯性肝囊肿19例

目的探讨经腹腔镜去顶开窗术治疗单纯性肝囊肿的方法及效果。方法对19例单纯性肝囊肿患者采用经腹腔镜去顶开窗术,回顾性分析患者的临床资料。结果 19例患者中18例完成腹腔镜肝囊肿去顶开窗术,平均手术时间52 min,术中出血40~95 ml,引流澄清透明囊液65~340 ml,平均住院时间5.5d。患者术后24 h下床活动,进半流食,未使用镇痛药物。术后2~3 d拔除引流管,无出血、胆漏等并发症发生。随访6~11个月,B超复查未见囊肿复发。1例因胆汁外漏明显中转开腹手术治愈。结论腹腔镜肝囊肿去顶开窗术创伤小、恢复快、住院时间缩短,但应严格掌握手术适应征,正确细致操作。     

开窗减压术治疗牙源性囊肿的临床研究

目的:评价牙源性囊肿初期行开窗减压术治疗的临床疗效.方法:回顾2005年2月～2012年2月65例经开窗减压术治疗的牙源性囊肿病例,随访6个月～7年,进行临床、影像学及病理学检查,通过曲面断层片测量减压术前及术后病灶的长径变化,评价临床疗效,随访观察复发情况.结果:囊性病损减小约75.2％,平均减压时间约(8.3±4.2)个月,其中小于等于18岁的患者一般约为7.3个月,成人约11.3个月(P＜0.05),小于10cm2的囊肿平均减小率约为0.13,大于20cm2的囊肿平均减小率约为0.09,二者无显著性差异(0.0815),小于等于18岁者减小率约为0.15,成人约为0.08(P＜0.05).1例牙源性角化囊性瘤方法,经二期手术治愈.结论:开窗减压术治疗牙源性角化囊肿是一种安全、可靠、有效的治疗方法.对于年轻患者其减压时间相对较短,但对于进展性牙源性囊肿,仍推荐行二期手术治疗.     

腹膜后腹腔镜治疗复杂性肾囊肿21例报告

目的:评价腹膜后腹腔镜肾囊肿去顶减压术治疗复杂性肾囊肿的疗效.方法:回顾分析2009年1月至2010年8月为21例复杂性肾囊肿患者施行腹膜后腹腔镜肾囊肿去顶减压术的临床资料.结果:本组20例患者顺利完成腹膜后腹腔镜去顶减压术,手术时间30~120min,平均50min;术中出血10~100ml,平均30ml;术后住院3...     

口腔矫治器配合开窗引流术治疗儿童发育期含牙囊肿的临床应用

目的：研究口腔矫治器配合开窗引流术治疗儿童发育期含牙囊肿保留恒牙胚的临床疗效。方法：对30例替牙期儿童发育期含牙囊肿病例,采用口腔矫治器配合口腔颌面外科手术开窗引流保留恒牙胚的方法进行治疗。随访观察1～2年,根据X线片和临床症状评价疗效。结果：术后6～12个月囊腔阴影消失,牙齿萌至龈缘,牙根形成良好。13～18个月牙齿大多正常萌出,咬合关系良好。结论：口腔矫治器配合开窗引流手术治疗儿童发育期含牙囊肿效果良好,能够达到保牙和保骨的效果,值得临床推广应用。     

The Supposed Intracavernous Sinus Arachnoid Cyst with Abducens Neuropathy: A Case Report

Intracavernous sinus arachnoid cysts are rare intracranial congenital lesions. When present, their anatomic location frequently results in cranial nerve palsy. A 15-year-old boy was admitted to our hospital with diplopia, which had gradually worsened over the previous several months. An arachnoid cyst was identified within the right cavernous sinus and fenestration surgery was performed. The patient recovered well and three months after the surgery, diplopia was disappeared. Surgical decompression of the intracavernous sinus arachnoid cyst is beneficial for symptomatic patients with this condition.     

经脐单孔腹腔镜肝囊肿开窗术

目的总结经脐单孔腹腔镜肝囊肿开窗术的疗效。方法回顾性分析3例经脐单孔腹腔镜肝囊肿开窗术患者临床资料。结果 3例手术均获成功,平均手术时间55（50～60）min,无胆漏、出血、切口感染、切口疝等并发症发生。平均住院时间8.3（8～9）d。平均随访7（3～12）个月,囊肿无复发。结论经脐单孔腹腔镜肝囊肿开窗术是一种安全而又有效的手术,随着器械的改进和术者经验的积累,可作为常规手术方法应用于临床。     

Laparoscopic fenestration of biliary cysts.

We describe a new technique of biliary cyst fenestration using a videolaparoscopic approach. From June 1989 to October 1990, laparoscopic fenestration was performed for four symptomatic solitary cyst and one polycystic liver disease patients, without any morbidity. Mean hospital stay was short: 6.8 days (range of 3-14 days). No recurrence was observed on ultrasound controls with a mean follow-up of 6.4 months (range of 2-15 months). Laparoscopic fenestration for symptomatic biliary cysts is a simple, effective, and minimally invasive procedure.     

Hemifacial spasm associated with an ependymal cyst in the cerebellopontine angle. Case report

No previous case of hemifacial spasm associated with an ependymal cyst has been reported in the literature. In this article the authors report the first case in which hemifacial spasm accompanied an ipsilateral cerebellopontine angle ependymal cyst in a 27-year-old woman. Cyst fenestration and arterial decompression of the facial nerve at the root exit zone resulted in complete resolution of the patient's symptoms. A histopathological study including immunohistochemical methods identified an ependymal cyst.     

Fiberscopic fenestration and prophylactic stenting of periaqueductal cysts: technical report on three cases.

The authors report on three consecutive cases of periaqueductal cysts, causing non-communicating hydrocephalus, successfully treated with endoscopic fenestration and aqueductal stenting. Navigation and cyst fenestration were accomplished using a slim (1.1 mm outside diameter) optic fiberscope inserted via a pre-coronal-paramedian burr hole. Third ventriculostomy was also performed after cyst fenestration in two cases. Because of the lack of data regarding such lesions and the possible recurrence with simple fenestration, an aqueductal stent connected to a subcutaneous reservoir was placed, in all 3 cases, under direct visualization. Average duration of the procedure was less than sixty minutes and there were no intra- or perioperative complications. All patients recovered clinically and their postoperative neuroimaging assessment confirmed a decrease in size of both the ventricular system and cyst (mean follow-up: 6.8 months). The authors conclude than this minimally invasive procedure is a promising, safe and effective method to treat cerebral symptomatic periaqueductal cysts and associated non-communicating hydrocephalus.     

微创伤技术治疗非寄生虫性肝囊肿的评价

目的：探讨非寄生虫性肝囊肿外科治疗的最佳治疗方法。方法：回顾分析52例治疗过程及结果,穿刺注射法27例,腹腔镜囊肿开窗14例,开腹手术11例。结果：开腹手术效果确实,但创伤大,恢复慢;穿刺注射法及腹腔镜囊肿开窗14例,开腹手术11例。结果：开腹手术效果确实,但创伤大,恢复慢;穿刺注射法及腹腔镜囊肿开窗法创伤轻,痛苦小,住院时间短。直径8cm以上囊肿穿刺注射无水乙醇,囊肿于6个月内消失,囊肿越大,越适合腹腔镜开窗法治疗。结论：应用微创伤技术治疗非寄生虫性肝囊肿具有良好的临床效果,合理选择治疗方法十分重要。     

Microsurgical keyhole approach for middle fossa arachnoid cyst fenestration

OBJECTIVE: The optimal surgical treatment for symptomatic temporal arachnoid cysts is controversial. Therapeutic options include cyst shunting, endoscopic fenestration, and craniotomy for fenestration. We reviewed the results for patients who were treated primarily with craniotomy and fenestration at our institution, to provide a baseline for comparisons of the efficacies of other treatment modalities. METHODS: A retrospective review of data for 50 children who underwent keyhole craniotomy for fenestration of temporal arachnoid cysts between 1994 and 2001 was performed after institutional review board approval. During that period, the first-line treatment for all symptomatic middle fossa arachnoid cysts was microcraniotomy for fenestration. Microsurgical dissection to create communications between the cyst cavity and basal cisterns was the goal. All patient records were reviewed and numerous variables related to presentation, cyst size and classification, treatment, cyst resolution, symptom resolution, follow-up periods, and cyst outcomes were recorded. RESULTS: Fifty temporal arachnoid cysts in 50 treated patients were identified. The average age at the time of surgery was 68 +/- 57.2 months. The follow-up periods averaged 36 months. There were 34 male and 16 female patients in the series. Twenty-six cysts were on the left side. Indications for surgery included intractable headaches (45%), increasing cyst size (21%), seizures (25%), and hemiparesis (8%). The symptoms most likely to improve were hemiparesis (100%) and abducens nerve palsies. Headaches (67%) and seizure disorders (50%) were less likely to improve. Nine patients exhibited progressive increases in cyst size in serial imaging studies. Those patients were monitored for a mean of 40 +/- 23 months before intervention. In the entire series, 82% of patients demonstrated decreases in cyst size in serial imaging studies. Of those patients, 18% demonstrated complete cyst effacement. Overall, 83% of patients with Grade II cysts and 75% of patients with Grade III cysts exhibited evidence of decreases in cyst size in long-term monitoring. Two patients required shunting after craniotomy (4%). Hospital stays averaged 3.4 days. Total surgical times averaged 115 minutes. No significant blood loss occurred (5-50 ml). Complications included spontaneously resolving pseudomeningocele (10%), transient Cranial Nerve III palsy (6%), cerebrospinal fluid leak (6%), subdural hematoma (4%), and wound infection (2%). CONCLUSION: A microsurgical keyhole approach to arachnoid cyst fenestration is a safe effective method for treating middle fossa cysts. This procedure can be performed with minimal morbidity via a minicraniotomy. Compared with an endoscopic approach, better control of hemostasis can be obtained, because of the ability to use bipolar forceps and other standard instruments. The operative time and length of hospital stay were not excessively increased.     

经椎板开窗减压复位加经椎弓根植骨和内固定术治疗胸腰椎爆裂性骨折

目的分析经后路椎弓根内固定加经椎板开窗椎管减压和经椎弓根椎体植骨治疗胸腰椎爆裂性骨折的疗效。方法对28例胸腰椎新鲜爆裂性骨折,患者应用后路椎弓根内固定复位,椎板开窗减压+经伤椎椎弓根向椎体前缘植入自体骨及同种异体骨或人工骨。结果术后椎体高度及生理弧度恢复满意,经随访18个月,椎体高度无明显丢失,椎体无塌陷变形,无内固定松动、断裂。结论经后路椎弓根内固定+经椎板开窗减压复位+经椎弓根椎体植骨治疗胸腰椎新鲜爆裂性骨折,手术安全,效果满意,术后并发症低,远期脊柱稳定性好。