保存性外科治疗突入上颌窦后份牙源性囊性病变疗效评价

中国口腔颌面外科杂志 ›› 2017, Vol. 15 ›› Issue (4): 324-328.

保存性外科治疗突入上颌窦后份牙源性囊性病变疗效评价

胡颖恺，杨驰，徐光宙，郑凌艳

上海交通大学医学院附属第九人民医院·口腔医学院口腔外科, 上海市口腔医学重点实验室，上海 200011

收稿日期:2016-09-26 出版日期:2017-08-10 发布日期:2017-08-14
通讯作者: 杨驰，E-mail：yangchi63@hotmail.com
作者简介:胡颖恺（1990-），女，在读博士研究生，E-mail：echohyk@foxmail.com
基金资助:
上海市科学技术委员会科研计划项目（14DZ2294300）；上海高校高峰高原学科建设项目

Efficacy of conservative surgery for odontogenic cysts intruding into posterior part of maxillary sinus

HU Ying-kai, YANG Chi, XU Guang-zhou, ZHENG Ling-yan

Department of Oral Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine； Shanghai Key Laboratory of Stomatology. Shanghai 200011, China

Received:2016-09-26 Online:2017-08-10 Published:2017-08-14

摘要/Abstract

摘要： 目的：通过临床、影像随访综合评价保存性手术治疗上颌窦后份牙源性囊肿的手术成功率，探讨其有效性和优缺点。方法：回顾2011年12月—2014年12月施行保存性手术治疗牙源性上颌窦囊性病变的患者，进行临床和影像学随访和评价。两者评价均分为优、良、差3级，将优和良视为手术有效。采用SPSS 17.0软件包中的Fisher确切概率法，比较临床和影像评价的有效率是否具有差异。结果：21例患者施行保存性手术，19例接受随访。随访期为3~31个月（平均14.4月）。术后1例患者发生感染，手术成功率为94.74%（18/19）；2例出现暂时性面部和牙轻度感觉异常，3个月后均恢复正常；均无鼻窦症状及面部畸形和永久性面部麻木等并发症；1例牙源性角化囊性瘤术后7个月复发，重行保存性手术，随访11个月后无复发；螺旋CT复查见上颌窦黏膜腔有不同程度增大，窦壁有新骨形成，上颌窦炎消失或好转。结论：保存上颌窦黏膜及骨板不但手术成功率高，并发症少，而且有利于保存上颌窦的生理功能和黏膜腔体积扩大，保持上颌骨外形。

关键词: 牙源性上颌窦囊性病变, 保存性手术, 疗效评价

Abstract: PURPOSE: The aim of the study was to evaluate the clinical effectiveness of conservative surgery for odontogenic cysts (OCs) intruding into posterior part of maxillary sinus through clinical and radiological examination, as well as to discuss its superiority and validity. METHODS: This retrospective study included patients with OC intruding into posterior part of maxillary sinus from December 2011 to December 2014. Clinical and radiological examinations were performed for each patient, and both evaluations had three grades of excellent, good and poor. Cases evaluated as excellent and good were considered success. Fisher's exact probability was performed to compare the effective rate of the 2 examinations with SPSS 17.0 software package. RESULTS: There were 21 cases who underwent conservative surgeries, 19 out of them came back for follow-up. The follow-up interval was from 3 months to 31 months (mean, 14.4 months). Suppurative inflammation was observed in 1 patient, and the success rate was 94.74% (18/19). Two cases presented mild facial paresthesia but recovered 3 months later. Facial asymmetry and permanent nerve damage were absent. Relapse occurred in 1 case of keratocystic odontogenic tumor, and conservative surgery was re-performed. CT images showed sinus cavity increased after surgery, and new bone formation could be seen on the sinus floor. The maxillary sinusitis disappeared or recovered significantly. CONCLUSIONS: Sinus mucosa and bony wall preservation can protect normal physiological function and contour of the maxillary sinus, leading to fewer postoperative complications and higher success rate.

Key words: Odontogenic maxillary sinus disease, Conservative surgery, Efficacy evaluation

中图分类号:

R739.8

胡颖恺，杨驰，徐光宙，郑凌艳. 保存性外科治疗突入上颌窦后份牙源性囊性病变疗效评价[J]. 中国口腔颌面外科杂志, 2017, 15(4): 324-328.

HU Ying-kai, YANG Chi, XU Guang-zhou, ZHENG Ling-yan. Efficacy of conservative surgery for odontogenic cysts intruding into posterior part of maxillary sinus[J]. China J Oral Maxillofac Surg, 2017, 15(4): 324-328.

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