泪前入路与传统手术治疗上颌窦内翻性乳头状瘤的比较
Prelacrimal approach vs conventional surgery for inverted papilloma in the maxillary sinus.
作者信息
Nakayama Tsuguhisa, Tsunemi Yasuhiro, Kuboki Akihito, Asaka Daiya, Okushi Tetsushi, Tsukidate Toshiharu, Otori Nobuyoshi, Kojima Hiromi, Haruna Shin-Ichi
机构信息
Department of Otorhinolaryngology, Jikei University School of Medicine, Tokyo, Japan.
Department of Otorhinolaryngology-Head and Neck Surgery, Dokkyo Medical University, Tochigi, Japan.
出版信息
Head Neck. 2020 Nov;42(11):3218-3225. doi: 10.1002/hed.26376. Epub 2020 Jul 8.
BACKGROUND
The prelacrimal approach, termed endoscopic modified medial maxillectomy (EMMM), has recently been applied for treatment of inverted papilloma (IP) in the maxillary sinus. EMMM provides wider access to the maxillary sinus while preserving the inferior turbinate and nasolacrimal duct.
METHODS
We reviewed patients with IP in the maxillary sinus to compare the surgical results obtained by conventional surgery (ie, endoscopic maxillary sinus antrostomy or in combination with the Caldwell-Luc approach) with those obtained by EMMM.
RESULTS
All patients had a T3 on the Krouse staging system, and the average follow-up time was 46.0 months. Of the 18 patients in the conventional group, recurrence was seen in 3 patients (16.6%). No recurrence was seen in the 27 patients who showed preservation of the inferior turbinate and nasolacrimal duct, and no complications occurred in the EMMM group.
CONCLUSIONS
EMMM is an effective surgical approach that reduces recurrence with fewer complications.
背景
泪前入路，即内镜改良上颌骨内侧切除术（EMMM），最近已应用于上颌窦内翻性乳头状瘤（IP）的治疗。EMMM在保留下鼻甲和鼻泪管的同时，能更广泛地进入上颌窦。
方法
我们回顾了上颌窦IP患者，比较传统手术（即内镜上颌窦开窗术或联合Caldwell-Luc入路）与EMMM的手术结果。
结果
所有患者在Krouse分期系统中均为T3期，平均随访时间为46.0个月。传统组的18例患者中，3例（16.6%）出现复发。在27例保留了下鼻甲和鼻泪管的患者中未出现复发，EMMM组也未发生并发症。
结论
EMMM是一种有效的手术方法，可减少复发并降低并发症发生率。
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