波及上颌窦的大型颌骨囊肿的治疗及临床效果

目的:探讨侵犯上颌窦的大型颌骨囊肿的治疗和临床效果。方法 :回顾2007-07—2015-03期间,在本院治疗的72例侵犯上颌窦的颌骨囊肿患者。A组(n=36)术中联合用超声骨刀和鼻内镜,彻底清除病变组织,保存正常窦内黏膜及骨骼外形;B组(n=36)术中用骨凿、咬骨钳去除骨壁,摘除囊壁组织后用刮匙搔刮囊腔及行上颌窦根治术。术后随访观察3~72个月,对术后并发症进行对比观察和统计学分析。采用SPSS13.0软件包对数据进行χ2检验。结果:A组患者在上颌窦瘘、面部畸形、鼻通气功能方面,术后并发症发生率显著低于B组(P<0.05);颌面部的美观和功能恢复良好。结论:术中用超声骨刀和鼻内镜治疗侵犯上颌窦的大型颌骨囊肿,保存正常窦内黏膜及骨骼外形,可明显降低上颌窦瘘和鼻通气下降的发生,颌面部的美观和功能恢复较满意。

Piezosurgery and Endoscopic Assistance in the Treatment of Jaw Cysts Involving the Maxillary Sinus

Objective: To discuss and compare the effects of piezosurgery and endoscopic assistance in the treatment of large jaw cysts involving the maxillary sinus. Methods: 72 patients of large jaw cyst with infringement of maxillary sinus from July 2007 to March 2015 were divided into two groups and retrospectively reviewed. Group A (n=36), the piezo-surgery and nasal endoscopic measures were collectively used. The jaw cysts were completely removed with preservation of the normal mucosa of maxillary sinus and contour of maxillary bone. Group B (n=36) a part of maxillary bone was cleaned by osteotome and bone forceps. The cyst wall was curetted, then the patients were underwent Caldwell-Luc opera-tion. After a follow-up of 3-72 months, the postoperative complications were recorded for assessment. Chi-square test and SPSS 13.0 software package were used for statistical analysis. Results: The incidence of postoperative complications such as maxillary sinus fistula, facial deformity, and nasal obstruction in group A were significantly lower than that in group B (P<0.05). The recovery of facial contour and masticatory function were better in group A patients. Conclusion: Piezo-surgery and nasal endoscopic assistance in the treatment of large jaw cysts involving the maxillary sinus can effectively de-crease the postoperative complications.