论文部分内容阅读
目的:介绍一种通过上颌窦前外侧壁取出上颌窦内异物的方法 ,以保存牙槽骨,并评价其临床疗效。方法 :收集2011年8月—2014年12月期间牙根等异物误入上颌窦的患者。记录牙位、病程、口腔-上颌窦瘘直径、治疗经过。拍摄全景片及CT后,采用超声骨刀经上颌窦前外侧壁开窗,根据异物位置和大小决定开窗大小,异物位置深在时则以内镜辅助定位。小开窗不复位骨板,大开窗复位骨板,以钛板固定。记录手术结果和时间、术后反应、口腔-上颌窦瘘愈合情况,以及并发症情况。结果:共取出12例进入上颌窦的异物,4例应用内镜辅助定位,3例做小开窗,9例做大开窗,异物均成功取出,手术时间少于20 min。术后疼痛时间平均5.7 d,肿胀时间平均14.3 d,3例出现0.5~5 d鼻腔渗血;牙槽骨形态丰满;口腔-上颌窦瘘均一期愈合;无面部麻木及感染。结论:应用该方法取出误入上颌窦异物的成功率高,具有微创、视野清楚、省时、并发症少等优点,值得推广。
OBJECTIVE: To introduce a method of removing foreign bodies in the maxillary sinus through the anterior lateral wall of the maxillary sinus in order to preserve the alveolar bone and evaluate its clinical efficacy. Methods: The patients who had strayed into the maxillary sinus during the period from August 2011 to December 2014 were collected. Recording teeth, duration, oral - maxillary fistula diameter, after treatment. After panoramic photography and CT scanning, an ultrasonic bone knife was used to open the anterior lateral wall of the maxillary sinus to determine the size of the fenestration according to the location and size of the foreign body. When the location of the foreign body was deep, endoscopic assisted positioning was performed. Small window does not reset the bone plate, large fenestration plate reduction, titanium plate fixation. Record the operation results and time, postoperative response, oral - maxillary sinus fistula healing, and complications. Results: A total of 12 foreign bodies entering the maxillary sinus were obtained, 4 cases were assisted by endoscopy, 3 cases were small fenestration and 9 cases were fenestration. The foreign bodies were successfully removed and the operation time was less than 20 minutes. The average time of postoperative pain was 5.7 days, the swelling time was 14.3 days on average, and nasal bleeding was observed in 0.5% to 5 days in 3 cases. The shape of alveolar bone was full. The oral-maxillary sinus fistula healed in one time. No facial numbness and infection were found. Conclusion: The method has the high success rate of removing foreign body into the maxillary sinus, with the advantages of minimally invasive, clear vision, time saving and less complications, which is worthy of popularization.