Brescia Giuseppe, Fusetti Stefano, Apolloni Federico, Marioni Gino, Saia Giorgia
Department of Neuroscience DNS, Otolaryngology Section, University of Padova, Padova, Italy.
Department of Neuroscience DNS, Maxillofacial Surgery Unit, University of Padova, Padova, Italy.
Ann Otol Rhinol Laryngol. 2019 Mar;128(3):177-183. doi: 10.1177/0003489418812898. Epub 2018 Nov 21.
Displacement of dental materials into the maxillary sinus occurs in daily dental practice; dental implants have become a new common foreign body (FB), as implantation has become routine. The main goal of the present study was to analyze an original series of patients consecutively treated for maxillary sinus FBs. A secondary goal was to propose a decision-making flowchart on the basis of the authors' experience and a critical analysis of literature to select the most appropriate surgical approach.
Eleven consecutive patients evaluated for maxillary sinus FBs consisting of dental material were considered.
For removal of the FBs, a nasal endoscopic approach was preferred in 5 cases, a nasal combined approach in 2 cases, an oronasal combined approach in 2 cases, and a lateral window approach in 2 cases. In 2 of 11 cases, complications were reported. A decision-making flowchart to select the best surgical approach is reported.
The correct choice and application of FB removal techniques allow minimization of unfavorable outcomes and creation of an appropriate environment for new dental treatment. Prospective, large series-based studies will be necessary to confirm the safety and clinical efficacy of the proposed decision-making flowchart.
在日常牙科诊疗中，牙科材料移位进入上颌窦的情况时有发生；随着种植牙植入已成为常规操作，种植牙已成为一种新的常见异物。本研究的主要目的是分析一系列连续接受上颌窦异物治疗的患者。次要目的是根据作者的经验和对文献的批判性分析，提出一个决策流程图，以选择最合适的手术方法。
纳入11例连续评估为上颌窦异物且异物为牙科材料的患者。
对于取出异物，5例首选鼻内镜入路，2例采用鼻联合入路，2例采用口鼻联合入路，2例采用外侧开窗入路。11例中有2例报告了并发症。报告了一个选择最佳手术方法的决策流程图。
正确选择和应用异物取出技术可将不良后果降至最低，并为新的牙科治疗创造适宜的环境。需要进行前瞻性、基于大样本系列的研究来证实所提出决策流程图的安全性和临床疗效。
