Yura Shinya, Kato Takumi, Ooi Kazuhiro, Izumiyama Yuri
Department of Oral and Maxillofacial Surgery, Tonami General Hospital, Tonami, Japan.
J Craniofac Surg. 2008 Nov;19(6):1650-2. doi: 10.1097/SCS.0b013e31817c347d.
We describe here 3 minimally invasive procedures for removing lesions from the maxillary sinus using an ultrathin endoscope, microscope, and otoscope.Preoperatively, a lesion in the maxillary sinus was identified by radiographic examination. Then the access hole position and advance direction of the endoscope and forceps were planned. Under local anesthesia, a small incision on the buccal mucosa was made in the planned position. The anterior bony wall of the sinus was exposed subperiosteally, and a small access hole for the insertion of an endoscope was made in the planned position and angled with a fissure bur. After identification of the lesion endoscopically, microscopically, or otoscopically, a forceps was inserted into the sinus cavity through the hole, and the lesion was seized and withdrawn from the sinus.The surgical procedures are suggested to be reliable, easy, and minimally invasive that provide a limited incision and bone removal and respect the integrity of the sinus.
我们在此描述了3种使用超薄内窥镜、显微镜和耳镜从上颌窦切除病变的微创手术方法。术前,通过影像学检查确定上颌窦内的病变。然后规划内窥镜和钳子的进入孔位置及推进方向。在局部麻醉下,于规划位置在颊黏膜上做一个小切口。在骨膜下暴露窦的前骨壁,并在规划位置用裂钻制作一个用于插入内窥镜的小进入孔并调整角度。在内窥镜、显微镜或耳镜下识别病变后,将钳子通过该孔插入窦腔内,夹住病变并从窦中取出。建议这些手术方法可靠、简便且微创,切口和骨切除有限,并尊重窦的完整性。