Oral and Maxillofacial Surgery and Traumatology.
Universidade do Sagrado Coração, Bauru, SP, Brazil.
J Oral Implantol. 2021 Dec 1;47(6):511-517. doi: 10.1563/aaid-joi-D-19-00301.
This study presents the case of a patient who required antrostomy under general anesthesia to treat a sinus lift complication. The patient was a 43-year-old woman with no systemic abnormalities who underwent maxillary sinus lift surgery associated with mineralized bovine bone graft. The Schneiderian membrane was perforated during the procedure, and the rupture was treated with collagen membranes to close the wound and contain the biomaterial, preventing its dispersion. The patient developed a maxillary sinus infection 7 days after surgery. This infection was initially treated with 875 mg amoxicillin combined with 125 mg clavulanic acid. Although the initial infection did not worsen, the patient developed maxillary sinusitis. Thirty days after the onset of the initial infection, the patient underwent an intraoral surgery under local anesthesia to remove the biomaterial and clean the sinus cavity. Despite this procedure, maxillary ostial patency was still compromised, and antrostomy was performed endoscopically in a hospital setting under general anesthesia. This procedure resolved the sinus infection. Then, 12 months after hospitalization, the patient was treated with another sinus graft surgery without postoperative complications. The treatment of sinus infections caused by the graft surgery may require early and active intervention with antibiotics, graft removal, and antrostomy to prevent major complications.
本研究报告了一例需全身麻醉下施行上颌窦切开术以治疗鼻窦提升并发症的患者。患者为 43 岁女性,无全身异常,接受了上颌窦提升术联合矿化牛骨移植。术中穿破了黏膜,用胶原膜封闭伤口并包裹生物材料,防止其扩散,处理了破裂口。术后 7 天患者发生上颌窦感染。该感染最初采用 875 mg 阿莫西林联合 125 mg 克拉维酸治疗。尽管初始感染未恶化,但患者发生了上颌窦炎。初始感染发作 30 天后,患者在局麻下接受了经口内手术,以去除生物材料并清洁鼻窦腔。尽管进行了该手术,但上颌窦口仍不通畅,因此在全麻下于医院内行内镜下上颌窦切开术。该手术解决了鼻窦感染。然后,患者在住院后 12 个月接受了另一次鼻窦植骨术,术后无并发症。因植骨术导致的鼻窦感染的治疗可能需要早期积极采用抗生素、去除移植物和施行上颌窦切开术来预防严重并发症。