Unit of Oral Surgery, Department of Medicine, Surgery, and Dentistry, San Paolo Hospital-University of Milan, Italy.
Int J Oral Maxillofac Surg. 2009 Dec;38(12):1273-8. doi: 10.1016/j.ijom.2009.09.001. Epub 2009 Sep 24.
This study retrospectively analyses paranasal sinus complications following displacement of oral implants in the maxillary sinus treated according to clinical situation by functional endoscopic sinus surgery (FESS), an intraoral approach, or a combination of both procedures. Over 5 years, 27 patients (13 male; 14 female), aged 27-73 years (mean 53.9 years), underwent treatment for postoperative complications involving the paranasal sinuses following displacement of oral implants in the maxillary sinuses. According to the complication (implant displacement, implant displacement with or without reactive sinusitis and/or with or without associated oro-antral communication), patients were treated with FESS, intraoral approach to the sinus, or FESS associated with an intraoral approach. Follow up lasted for at least 1 year with clinical and radiographic controls. 26 patients recovered completely; one patient underwent re-intervention with FESS and an intraoral approach 2 years after implant removal, due to persistent signs and symptoms of maxillary sinusitis and oro-antral communication. Postoperative recovery after the second procedure was followed by complete recovery. The results demonstrate that a rational choice of surgical protocol for the treatment of complications involving the paranasal sinuses following displacement of implants in the maxillary sinuses may lead to reliable results.
本研究回顾性分析了功能性内窥镜鼻窦手术（FESS）、经口入路或两者联合治疗上颌窦内移位口腔种植体后发生的鼻窦并发症。5 年来，27 例（13 例男性；14 例女性）年龄 27-73 岁（平均 53.9 岁）的患者因上颌窦内移位口腔种植体后发生鼻窦并发症而行治疗。根据并发症（种植体移位、伴有或不伴有反应性鼻窦炎和/或伴有或不伴有相关的口鼻瘘），患者接受 FESS、鼻窦经口入路或 FESS 联合经口入路治疗。随访时间至少为 1 年，进行临床和影像学检查。26 例患者完全康复；1 例患者因上颌窦炎和口鼻瘘的持续症状和体征在种植体取出后 2 年接受了 FESS 和经口入路的再次干预。第二次手术后的恢复情况良好，完全康复。结果表明，对于上颌窦内移位种植体后鼻窦并发症的治疗，合理选择手术方案可能会获得可靠的结果。
