大型上颌骨囊肿的手术治疗

目的探讨大型上颌骨囊肿的手术治疗方法。方法对1999年2月至2008年12月经手术治疗的25例大型上颌骨囊肿进行总结分析。结果25例大型上颌骨囊肿经口内牙龈沟切口翻瓣显露摘除或刮除囊肿及炎性病变组织，严密缝合口内龈瓣创口，骨创腔内放置引流管自下鼻道或鼻底开窗引出作负压引流3d左右，术后伤口一期愈合，无裂开和瘘口形成，追踪观察1～2．5年，病情未见复发。结论大型上颌骨囊肿手术，彻底清除囊性病变组织，选择有健康坚硬骨壁支持处的牙龈沟切口，严密对合缝合伤口，建立充分有效的负压引流，是防止术后伤口愈合不良、形成瘘口及病情复发的有效方法。

Surgical Treatment of Large Maxillary Cysts

Objective To discuss and study the method of surgical treatment of large maxillary cysts. Methods Experiences of the 25 surgical treatment of large maxillary cysts during the period from February 1999 to December 2008 are reviewed, analysed and summarized. Results By the means of the following three steps, firstly, flap reflection and removal of the cut inside the gingival sulcus, or removal of the cyst and inflam- matory lesions tissue; secondly, sewing up the wound of gingival flap tightly; thirdly, putting a drainage tube into the cavity of the bone wound and carrying out negative pressure drainage for about 3 days right from the in- ferior nasal meatus or the basis nasi, the post-operation wound has become reunited during the first phase, with- out any wound dehiscence or orificium fistulae, and then medical follow-up observation would be conducted for one to two and a half years. It turns out that there is no recurrence of the patients＇disease. Conclusion Surgical treatment of large maxillary cysts is able to remove throughly the cystic lesions tissue. The most effective method for preventing the post-operation poor healing of the wound, orificium fistulae as well as the recurrence of the patients＇disease is to choose the gingival sulcus cut with healthy and strong bone basis supported, sew up the wound tightly and establish adequate and effective negative pressure drainage.