Aoki Satoshi, Omura Kazuhiro, Miyashita Keisuke, Otori Nobuyoshi, Haruna Shinichi, Tanaka Yasuhiro
Department of Otorhinolaryngology, Dokkyo Medical University Saitama Medical Center, Saitama, Japan.
Department of Otorhinolaryngology, The Jikei University School of Medicine, Tokyo, Japan.
Indian J Otolaryngol Head Neck Surg. 2021 Dec;73(4):504-509. doi: 10.1007/s12070-021-02658-x. Epub 2021 May 27.
Although the number of postoperative maxillary cyst (POMC) cases has declined recently, a few reports of refractory cases have also been reported. The indications for endoscopic sinus surgery (ESS) for POMC removal are broadening and attempts to prevent postoperative recurrence at the cyst opening site have been widely investigated. Here, we have advocated our original pedunculated mucoperiosteal flap (CLAP flap; covered lateral and posterior wall flap of the maxillary sinus), where the bony area exposed intraoperatively is covered, to prevent postoperative recurrence. We have also presented the method for creating the CLAP flap. We classified the POMC as being medial, lateral, or anterior superior type and performed ESS. We introduced the CLAP flap after 2015 for the lateral type and some of the medial types of POMCs. We examined the cyst opening rate using computed tomography, age, sex, cyst position, and a follow-up period in four patients (five sides) who did not undergo flap surgery, but who were managed in our hospital in 2015, and in eight patients (nine sides) who underwent the CLAP flap technique in our hospital. In the group with the CLAP flap, the cyst opening rate was significantly higher ( < 0.05). The CLAP flap was effective for preventing postoperative bony regrowth. It may be one of the options for covering the exposed bone surface as widely as possible.
The online version contains supplementary material available at 10.1007/s12070-021-02658-x.
尽管近年来术后上颌囊肿(POMC)的病例数有所下降,但仍有一些难治性病例的报道。用于切除POMC的鼻内镜鼻窦手术(ESS)的适应证正在扩大,并且已经广泛研究了预防囊肿开口部位术后复发的方法。在此,我们提倡使用我们原创的带蒂黏膜骨膜瓣(CLAP瓣;上颌窦覆盖外侧和后壁瓣),术中覆盖暴露的骨区域,以预防术后复发。我们还介绍了制作CLAP瓣的方法。我们将POMC分为内侧型、外侧型或前上型,并进行了ESS。对于外侧型和部分内侧型POMC,我们在2015年后引入了CLAP瓣。我们使用计算机断层扫描、年龄、性别、囊肿位置以及随访时间,对2015年在我院接受治疗但未接受瓣手术的4例患者(5侧)和接受CLAP瓣技术治疗的8例患者(9侧)的囊肿开口率进行了检查。在CLAP瓣组中,囊肿开口率显著更高(<0.05)。CLAP瓣对于预防术后骨质再生有效。它可能是尽可能广泛覆盖暴露骨表面的选择之一。
在线版本包含可在10.1007/s12070-021-02658-x获取的补充材料。