Kim Soung Min
Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea.
Eur Arch Otorhinolaryngol. 2017 Feb;274(2):1167-1171. doi: 10.1007/s00405-016-4416-4. Epub 2016 Dec 9.
Displacement of dental implants into the maxillary sinus is one of the rare complications during the implant surgery. However, it is always possible that clinicians confront with this unexpected result and patients should be informed ahead of maxillary implant surgery. For clinicians, it is important to be aware of how to deal with the complication, because the migrated implant must be removed as early as possible. There have been several classical ways to approach the maxillary sinus, such as the Caldwell-Luc procedure and endoscopic sinus surgery and these methods still have been chosen by many surgeons although quite a lot of complications exist. In this study, the author introduced a new sinus approach technique, modified endoscopic-assisted sinus surgery (MESS) as an efficient, easy and less complication-inducing sinus approach. A clinical case was described where a displaced dental implant beneath the optic nerve was successfully removed by MESS. Furthermore, essential considerations to avoid medical litigation and maintain close rapport with the patients were discussed when dealing with the case of displaced implant in the maxillary sinus.
牙种植体移位至上颌窦是种植手术中罕见的并发症之一。然而,临床医生始终有可能面临这种意外情况,因此在上颌种植手术前应告知患者。对于临床医生而言,了解如何处理该并发症非常重要,因为移位的种植体必须尽早取出。处理上颌窦有几种经典方法,如柯-陆氏手术和鼻内镜鼻窦手术,尽管存在不少并发症,但许多外科医生仍选择这些方法。在本研究中,作者介绍了一种新的鼻窦入路技术,即改良内镜辅助鼻窦手术(MESS),作为一种高效、简便且并发症较少的鼻窦入路方法。文中描述了一个临床病例,通过MESS成功取出了视神经下方移位的牙种植体。此外,还讨论了在处理上颌窦种植体移位病例时,避免医疗纠纷并与患者保持密切沟通的重要注意事项。