目的:研究累及上颌窦含牙囊肿患者采用鼻内镜经泪前隐窝入路手术治疗的可行性和疗效。方法:选择于我科住院治疗的上颌窦含牙囊肿患者14例,并在术前对所有患者行鼻内镜、CT以及口腔全景片检查。术中先将上颌窦自然口扩大借以对上颌窦内病变情况进行评估,进而切开下鼻甲头端鼻腔外侧壁,将鼻泪管下端游离出来,使之形成下鼻甲瓣-膜性鼻泪管,将其向前固定后形成上颌窦入路,最后通过0度鼻内镜进行上颌窦内大部分囊壁的切除以及异位牙的取出。手术完毕后将下鼻甲以及鼻泪管复位并将切口缝合。观察所有患者术中情况和术后临床效果。结果:在鼻内镜直视下,所有患者的上颌窦各壁均能良好地显露,并最大程度地将囊肿壁清除,顺利地将异位牙取出。术后全部患者均无鼻腔出血、坏死、鼻甲萎缩、鼻泪管损伤、鼻腔干燥、溢泪以及面部感觉障碍等并发症。随访6-36个月,全部患者术后临床症状慢慢消退,上颌窦自然口无堵塞,引流通畅,下鼻甲形态良好未见异常,均未见囊肿复发。结论:经鼻内镜泪前隐窝入路具有视野好、创伤少,并发症少,是一种治疗累及上颌窦含牙囊肿患者的理想手术路径。 Objective: To study the feasibility and efficacy of surgical treatment of patients with maxillary sinus with cyst by endoscopic sinus surgery. Methods: Fourteen patients with maxillary sinus cyst were selected for inpatient treatment in our department. All patients underwent endoscopic sinus surgery, CT and oral panoramic examination before operation. First surgery to expand the natural maxillary sinus mouth in order to assess the lesions in the maxillary sinus, and then cut under the nasal turbinate nasal lateral wall, the lower end of the nasolacrimal duct free to form the inferior turbinate flap - membranous nasolacrimal duct , Which will be fixed forward to form the maxillary sinus approach, and finally by 0 degrees endoscopic sinus maxillary sinus resection of most of the wall and ectopic teeth removed. After surgery, the inferior turbinate and nasolacrimal duct will be reset and the incision sutured. All patients were observed intraoperative situation and postoperative clinical effect. Results: Under endoscopic sinus surgery, all patients with maxillary sinus wall were well exposed, and to maximize the removal of cyst wall, the successful removal of heterotopic teeth. No postoperative nasal bleeding, necrosis, turbinate atrophy, nasolacrimal duct injury, nasal dryness, overflowing tears and facial sensory disturbances and other complications. All the patients were followed up for 6-36 months. The clinical symptoms of all patients subsided gradually. The maxillary sinus natural orifice was free of obstruction and drainage. No abnormality was found in inferior turbinate. No recurrence of cyst was found. Conclusion: The transnasal endoscopic approach for anterior recess of tears has the advantages of good field of vision, less trauma and fewer complications. It is an ideal surgical approach for the treatment of patients with maxillary sinus and cyst.