内镜辅助等离子射频消融手术治疗牙源性上颌窦炎近期疗效观察

目的:探讨采用内镜辅助下等离子射频消融手术治疗牙源性上颌窦炎的效果。方法:回顾性分析35例牙源性上颌窦炎患者的资料。其中采用内镜辅助下等离子低温射频治疗患者23例,手术从患侧上颌窦前壁开窗,鼻内镜经中鼻道开口或在开窗处进路,在内镜下探查炎症病灶的具体部位,在去除病灶牙的同时,应用等离子低温射频对上颌窦内病变黏膜部分进行多点消融。其他12例患者采用柯-陆手术治疗,比较2种方法的治疗效果。结果:采用柯-陆手术患者平均住院天数11d,12例患者术后面颊肿胀明显,7例出现面部麻木,6例出现牙疼痛。采用内镜辅助下等离子射频消融手术患者平均住院5d,且未出现上述并发症。内镜辅助射频治疗组术后3个月鼻道窦口完全恢复通畅。35例患者随访3个月时未见复发。结论:与柯-陆手术相比,采用内镜辅助下等离子低温射频消融手术治疗牙源性上颌窦炎在去除病灶的同时,减少了上颌窦黏膜和骨质的损伤,减少患者住院时间,利于术后恢复,临床疗效肯定。

The therapeutic effect of endoscopic-assisted radiofrequency plasma ablation on odontogenic maxillary sinusitis

PURPOSE: To explore the therapeutic effect of endoscopic-assisted on odontogenic maxillary sinusitis.METHODS: The clinical data of thirty-five patients with odontogenic maxillary sinusitis were retrospectively analyzed,including 23 cases who underwent endoscopic-assisted and 12 cases underwent Caldwell-Luc operation.treatment was applied under the help of antrotomy via middle nasal meatus with endoscope.The surgeon performed operations from anterior wall of maxillary sinus as approaches and used endoscope to locate the inflammatory area,and the treatment of radiofrequency plasma ablation was used to ablate the inflamed mucosa of maxillary sinus.In addition,12 patients underwent Caldwell-Luc operation.The effects of two kinds of operation were compared with each other.RESULTS: Patients with Caldwell-Luc operation were hospitalized for 11 days.The complication of Caldwell-Luc operation included facial swelling,facial numbness and toothache in 12 patients,7 patients and 6 patients,respectively.The mean hospital day of patients with endoscopic assisted-was 5 days.No complications occurred and the apertures of middle nasal meatus recovered to be unobstructed 3 months after operation.No recurrence was found during 3 months follow-up.CONCLUSION: Compared with Caldwell-Luc operation,endoscopic-assisted on odontogenic maxillary sinusitis reserved the normal maxillary sinus mucosa and reduced the length of patient stay as well as removed the inflammatory tissues.Therefore,endoscopic-assisted was beneficial to recovery of patients with operation.