上颌窦囊肿手术进路的选择

目的探讨鼻内镜下3种摘除上颔窦囊肿进路的选择。方法本组上颌窦囊肿共32例，术前均经鼻窦CT扫描和鼻内镜检查，明确鼻腔情况、囊肿的大小及位置。其中8例伴鼻窦炎鼻息肉者，经中鼻道自然口开放术进路行Messerkling术；19例单纯上颌窦囊肿患者，鼻内镜下经改良柯-陆进路行囊肿摘除术，另5例采用下鼻道开窗进路行囊肿摘除术。结果术后随访6个月～1年，鼻窦CT冠状位扫描或鼻内镜检查，19例经改良柯-陆进路者术后无复发；8例经中鼻道自然口开放术进路者，2例复发，1例术后窦口闭锁，中鼻甲与鼻腔外侧壁粘连；5例经下鼻道开窗进路者，1例复发，2例失访。结论3种术式各有优缺点，临床中应根据不同情况酌情选用。

Surgical approaches for maxillary sinus cyst

OBJECTIVE To investigate the surgical approaches for maxillary sinus cyst. METHODS A total of 32 patients with maxillary sinus cyst underwent operation for removal the cysts. Among them, 8 patients with maxillary sinus cyst and sinusitis were operated on through Messerklinger approach, 19 patients with maxillary cyst received modified CaldwellLuc operation under nasal endoscope and 5 patients received endoscopic removal of maxillary cyst through the maxillary sinus antrostomy at the inferior nasal meatus. RESULTS All the patients were followed up for 6 months to one year. There was no recurrence found in patients received modified CaldwelI-Luc operation. There were 2 patients recurred in 8 patients who were operated on through Messerklinger approach and one patient had closure of the maxillary sinus ostium and adhesion of nasal cavity. One patient recurred and 2 lost follow up in 5 patients who received endoscopic removal of maxillary cyst through the maxillary sinus antrostomy at the inferior nasal meatus. CONCLUSION The optimal surgical method for maxillary cyst is modified Caldwell-Luc operation under nasal endoscope. Messerklinger technique may suitable for patients with complicated sinusitis.