Obeso Sergio, Llorente José Luis, Pablo Rodrigo Juan, Sánchez Rafael, Mancebo Gonzalo, Suárez Carlos
Hospital Universitario Central de Asturias, Instituto Universitario de Oncología del Principado de Asturias, Oviedo, Asturias, España.
Acta Otorrinolaringol Esp. 2009 Sep-Oct;60(5):332-9. doi: 10.1016/j.otorri.2009.05.006. Epub 2009 Sep 5.
Traditional treatment for paranasal sinuses mucoceles recommended total removal through external approaches. Since the 90s, endoscopic marsupialization has been proposed as optimal surgical treatment. We present our experience in the treatment of this pathology.
A retrospective review of 72 patients treated for paranasal sinuses mucoceles between 1980 and 2006 in our ENT department was performed. We describe clinical features, surgical approaches employed and recurrence of disease.
The sample was composed of 72 patients with average follow-up period of 44 months (range 13-214 months). A total of 81 mucoceles were presented, with 44% affecting the frontal sinus or frontoethmoidal cells, followed in frequency by maxillary sinus mucoceles (35%). Twenty-nine percent of the patients did not present predisposing factors; 31% of patients had a history of nasal polyposis, 35% had undergone previous sinus surgery and 14% suffered previous facial fractures; 48 mucoceles patients were treated endoscopically and 33 were treated with external or combined approaches. Recurrence was found in 7 patients, 2 in the endoscopic surgery group and 5 in the external/combined surgery group.
Endoscopic marsupialization is a safe approach with a low rate of recurrence. The endoscopic approach may be unsuitable for frontal lateral sinus mucoceles or those with significant bone blockage.
传统的鼻窦黏液囊肿治疗方法建议通过外部入路进行完全切除。自20世纪90年代以来,内镜下造袋术已被提议作为最佳手术治疗方法。我们介绍我们在治疗这种疾病方面的经验。
对1980年至2006年间在我们耳鼻喉科接受鼻窦黏液囊肿治疗的72例患者进行回顾性研究。我们描述了临床特征、采用的手术入路和疾病复发情况。
样本由72例患者组成,平均随访期为44个月(范围13 - 214个月)。共出现81个黏液囊肿,其中44%累及额窦或额筛窦气房,其次是上颌窦黏液囊肿(35%)。29%的患者没有诱发因素;31%的患者有鼻息肉病史,35%的患者曾接受过鼻窦手术,14%的患者曾遭受面部骨折;48例黏液囊肿患者接受了内镜治疗,33例接受了外部或联合入路治疗。7例患者出现复发,内镜手术组2例,外部/联合手术组5例。
内镜下造袋术是一种安全的方法,复发率低。内镜入路可能不适用于额窦外侧黏液囊肿或有明显骨质阻塞的黏液囊肿。