Tükel H C, Tatli U
Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Çukurova University, Adana, Turkey.
Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Çukurova University, Adana, Turkey.
Int J Oral Maxillofac Surg. 2018 Sep;47(9):1189-1194. doi: 10.1016/j.ijom.2018.03.027. Epub 2018 Apr 11.
The aim of this study was to identify the risk factors associated with sinus membrane perforation and the effect of sinus membrane perforation and other risk factors on graft success and postoperative sinusitis. Sinus membrane perforation, graft failure, and postoperative sinusitis were tested for an association with age, sex, operator experience, side of the operation, residual bone height, presence of septa, presence of a mucous retention cyst, and smoking (χ test). Logistic regression analysis was used to model the odds ratio (OR) with corresponding risk factors. One hundred and twenty patients were included in this study. A total of 22 (18.3%) perforations occurred. A residual bone height of 3-6mm (OR 6.808, P=0.002) and presence of septa (OR 4.023, P=0.025) were identified as significant risk factors. Twenty-eight (23.3%) sinus grafts were classified as failed. Membrane perforation (OR 16.819, P<0.005) and residual bone height of 3-6mm (OR 5.363, P=0.01) were identified as significant risk factors for graft failure. None of the risk factors investigated in this study was significantly associated with postoperative sinusitis. These results suggest that the presence of septa and a residual bone height of 3-6mm are associated with an increased risk of sinus membrane perforation, and that sinus membrane perforation has a negative effect on graft success.
本研究的目的是确定与鼻窦黏膜穿孔相关的危险因素，以及鼻窦黏膜穿孔和其他危险因素对植骨成功及术后鼻窦炎的影响。对鼻窦黏膜穿孔、植骨失败和术后鼻窦炎与年龄、性别、术者经验、手术侧别、剩余骨高度、间隔的存在、黏液潴留囊肿的存在以及吸烟情况进行相关性检验（χ检验）。采用逻辑回归分析对相应危险因素的比值比（OR）进行建模。本研究共纳入120例患者。共发生22例（18.3%）穿孔。剩余骨高度为3 - 6mm（OR 6.808，P = 0.002）和存在间隔（OR 4.023，P = 0.025）被确定为显著危险因素。28例（23.3%）鼻窦植骨被判定为失败。黏膜穿孔（OR 16.819，P < 0.005）和剩余骨高度为3 - 6mm（OR 5.363，P = 0.01）被确定为植骨失败的显著危险因素。本研究中所调查的危险因素均与术后鼻窦炎无显著相关性。这些结果表明，间隔的存在和3 - 6mm的剩余骨高度与鼻窦黏膜穿孔风险增加相关，且鼻窦黏膜穿孔对植骨成功有负面影响。
