Department of Otolaryngology-Head and Neck Surgery and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Department of Otolaryngology-Head and Neck Surgery and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Int J Oral Maxillofac Surg. 2020 Jul;49(7):966-972. doi: 10.1016/j.ijom.2020.01.009. Epub 2020 Jan 28.
The aims of this retrospective clinical study were to present our management protocol for the retrieval of impacted dental implants that have become displaced into the maxillary sinus cavity and to define the role of endoscopic sinus surgery in this setting. All 24 patients (25 implants) who underwent surgical retrieval of dental implants displaced into the maxillary sinus between 2012 and 2019 were included. Data on surgical interventions and complications were collected retrospectively. Eleven patients (46%) had chronic sinusitis associated with the migrated implant. All implants were successfully retrieved via transnasal endoscopic approach alone: 80% via a middle meatal antrostomy and 20% via a combined middle and inferior meatal antrostomy. Five patients required a concomitant transoral approach for oro-antral fistula repair. None required a transoral approach for displaced implant retrieval. All patients healed uneventfully without complications. Transnasal endoscopic sinus surgery via a middle meatal antrostomy or a combined middle and inferior antrostomy is recommended as the primary choice for dental implant retrieval from the maxillary sinus. A transoral approach should be performed simultaneously only for oro-antral fistula repair. This surgical protocol proved to be safe and efficient, and it obviated the need for osteotomies of the anterolateral maxillary wall.
本回顾性临床研究的目的在于介绍我们对已移位至上颌窦腔内的种植体进行取出的管理方案，并确定鼻窦内镜手术在此情况下的作用。纳入了 2012 年至 2019 年间接受外科手术取出上颌窦内移位种植体的 24 名患者（25 个种植体）。回顾性收集了手术干预和并发症的数据。11 名患者（46%）存在与移位种植体相关的慢性鼻窦炎。所有种植体均通过经鼻内镜单独成功取出：80%通过中鼻道切开术，20%通过中鼻道和下鼻道联合切开术。5 名患者需要同期经口入路修复口-上颌窦瘘。无患者需要经口入路取出移位的种植体。所有患者均未出现并发症而顺利愈合。经中鼻道切开术或中鼻道和下鼻道联合切开术的经鼻内镜鼻窦手术被推荐为上颌窦内种植体取出的首选方法。仅在需要修复口-上颌窦瘘时才应同时进行经口入路。该手术方案安全有效，避免了对前外侧上颌骨壁进行截骨术。
