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[上颌窦异物]

[Foreign bodies in maxillary sinus].

作者信息

Bodet Agustí Eduard, Viza Puiggrós Ignacio, Romeu Figuerola Coia, Martinez Vecina Vicenç

机构信息

Unidad de Otorrinolaringología, Hospital Nostra Senyora de Meritxell, Andorra.

出版信息

Acta Otorrinolaringol Esp. 2009 May-Jun;60(3):190-3.

Abstract

INTRODUCTION

Foreign bodies in maxillary sinus (FBMS), whatever their origin or nature, are an unusual clinical condition. Diagnosis is based on the radiological findings in a clinical context of unilateral chronic rhinosinusitis. Treatment is the surgical removal of the intrasinusal foreign body.

PATIENTS AND METHODS

To identify FBMS, the records of 68 patients with unilateral chronic rhinosinusitis operated on from 2000 to 2007 were reviewed.

RESULTS

From 68 records reviewed, we found 11 (16 %) FBMS. Ten (91 %) of these 11 foreign bodies were thought to come from the teeth and the last 1 (9 %) had a non odontogenic origin. Eight of the 11 (73 %) patients with FBMS presented with chronic maxillary sinusitis symptoms and all patients showed radiological findings. Treatment was the surgical removal of the foreign body, in 9 (82 %) patients through endonasal approach by functional endoscopic sinus surgery (FEES) and in the other 2 (18 %) patients a mixed surgical procedure by endonasal meatotomy and oral antrotomy was required.

CONCLUSIONS

Chronic maxillary sinusitis showing FBMS is rare and it must be suspected with a prior history of dental procedures. The most frequent source of FBMS is material of odontogenic origin, and non-odontogenic origin secondary to an external injury in an accident or assault is much more unusual. We also review the nature of these foreign bodies, their clinical implications and treatment options.

摘要

引言

上颌窦异物(FBMS),无论其来源或性质如何,都是一种不常见的临床病症。诊断基于单侧慢性鼻-鼻窦炎临床背景下的影像学检查结果。治疗方法是手术取出鼻窦内的异物。

患者与方法

为了确定上颌窦异物,我们回顾了2000年至2007年接受手术治疗的68例单侧慢性鼻-鼻窦炎患者的病历。

结果

在回顾的68份病历中,我们发现了11例(16%)上颌窦异物。这11例异物中,有10例(91%)被认为来自牙齿,最后1例(9%)起源非牙源性。11例上颌窦异物患者中有8例(73%)表现为慢性上颌窦炎症状,所有患者均有影像学检查结果。治疗方法是手术取出异物,9例(82%)患者通过功能性鼻内镜鼻窦手术(FEES)经鼻内途径取出,另外2例(18%)患者需要经鼻内肉切开术和口腔上颌窦切开术的联合手术。

结论

显示上颌窦异物的慢性上颌窦炎很罕见,如有牙科手术史则必须怀疑。上颌窦异物最常见的来源是牙源性物质,继发于事故或袭击中外伤的非牙源性来源则更为罕见。我们还回顾了这些异物的性质、临床意义及治疗选择。

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