传统上颌窦根治术后上颌窦骨质增生瘢痕形成的临床观察

目的: 研究传统上颌窦根治术后上颌窦局部骨质增生与瘢痕形成的病理改变情况,并讨论其临床意义. 方法: 回顾性分析136例曾行传统上颌窦根治术,后因复发鼻窦炎或鼻息肉来我院就诊且需行手术治疗的患者,术前CT扫描分析上颌窦骨质增生及窦腔容积变化程度以及术中内镜下观察上颌窦腔及下鼻道开窗情况. 结果: 在136例中有48例(35%)术前CT检查发现上颌窦腔密度增高,明显骨质增厚. 手术发现窦腔明显缩小,腔内大量瘢痕. 在48例骨质增生患者中有22例(46%)下鼻道开窗闭锁. 在术前CT显示无上颌窦腔密度增高及骨质增厚的88例病例中,有26例(30%)术中发现有单纯性下鼻道开窗闭锁. 结论: 传统上颌窦根治术可引起上颌窦腔骨质增厚瘢痕形成,降低并发症的重要方法是严格掌握适应症.

Clinical observation on hyperosteogeny and scar formation of maxillary sinus after conventional maxillary sinus radical operation

AIM: To study the pathological changes of maxillary sinus in the patients after conventional maxillary radical treatment, Caldwell-Luc operation, and discuss its clinic significance. METHODS: Retrospective analysis was conducted in 136 patients who needed operation again due to recurrence of nasosinusitis and polyp after Caldwell-Luc operation. The hyperosteogeny and cavity volume of maxillary sinus were detected by pre-operative CT scanning. The local situations of maxillary sinus intra-cavity and inferior meatal opening were observed during functional endoscopic sinus surgery. RESULTS: The increased intra-cavity densities and osseous hyperplasia of maxillary sinus were seen in 48 cases of these 136 patients (35%) by CT examination. Large amounts of scar tissues were found in maxillary sinus cavities during the operation in the 48 cases, and 22 cases of which (46%) developed imperforation of inferior meatal openig. Besides, the occurrence of simple imperforation was confirmed during operation in 26 cases of the 88 patients (30%) without positive finding of pre-operative CT examination. CONCLUSION: The conventional maxillary radical treatment, Caldwell-Luc operation, can lead to hyperosteogeny and scar formation of maxillary sinus. So, it is important to strictly master the indications for decreasing the incidence of complications.