Zhou Chuan, Sun Su-Zhen, Lin Meng-Na, He Fu-Ming
Int J Oral Maxillofac Implants. 2021 Sep-Oct;36(5):885-893. doi: 10.11607/jomi.8842.
To investigate the influence of lateral window sinus augmentation on sinus physiology, including sinus membrane thickness and the outcome of antral pseudocysts.
This retrospective study was performed by reviewing all lateral window sinus augmentation procedures, which were done between the years 2013 and 2015. Each enrolled patient had CBCT images preoperatively (T0), immediately postoperatively (T1), and 6 months postoperatively (T2). The sinus membrane thickness, pseudocyst dimensions, and intraoperative perforation were evaluated. Patient-related factors such as age and sex that could influence the mucosal properties were also analyzed.
Based on established inclusion criteria, 306 patients with 320 sinuses were included in this study. The overall mean thickness of the sinus membrane (T0) was 1.30 ± 1.08 mm, and membrane thickening (> 2 mm) was observed in 22.19% of the sinuses. Preexisting pseudocysts were identified in 24 sinuses (7.50%), most of which remained unchanged or disappeared after 6 months. The intraoperative membrane perforation rate was lowest (1.96%) when the membrane thickness was 1.0 to 1.5 mm, and the perforation rate was increased in patients with thickened (> 2 mm) or thinned (≤ 1 mm) membrane. Membranes swelled immediately after operation (T1 vs T0, P < .01) and gradually recovered at 6 months. No significant change in membrane thickness was shown after the sinus augmentation procedure in the perforation group and pseudocyst group. The mean thickness of the sinus membrane at T0 and T1 was significantly higher for male subjects (P < .01).
Lateral window sinus augmentation has little or no impact on sinus membrane thickness and antral pseudocysts after a 6-month healing period, except for a transient mild membrane swelling. Thickened and thinned membrane were risk factors for intraoperative perforation. Small-sized perforation and pseudocysts might not contraindicate sinus augmentation from the standpoint of the surgical impact on the sinus membrane.
探讨外侧开窗式上颌窦提升术对鼻窦生理功能的影响，包括窦膜厚度及上颌窦假性囊肿的转归。
本回顾性研究通过查阅2013年至2015年间所有外侧开窗式上颌窦提升手术病例进行。纳入的每位患者术前（T0）、术后即刻（T1）及术后6个月（T2）均有CBCT图像。评估窦膜厚度、假性囊肿大小及术中穿孔情况。还分析了年龄和性别等可能影响黏膜特性的患者相关因素。
根据既定纳入标准，本研究纳入了306例患者的320个鼻窦。窦膜（T0）的总体平均厚度为1.30±1.08mm，22.19%的鼻窦观察到膜增厚（>2mm）。24个鼻窦（7.50%）发现有既往存在的假性囊肿，其中大多数在6个月后保持不变或消失。当膜厚度为1.0至1.5mm时，术中膜穿孔率最低（1.96%），膜增厚（>2mm）或变薄（≤1mm）的患者穿孔率增加。术后膜立即肿胀（T1与T0相比，P<.01），并在6个月时逐渐恢复。穿孔组和假性囊肿组在进行上颌窦提升手术后，膜厚度无显著变化。男性受试者在T0和T1时窦膜的平均厚度显著更高（P<.01）。
外侧开窗式上颌窦提升术在6个月的愈合期后对窦膜厚度和上颌窦假性囊肿几乎没有影响，除了短暂的轻度膜肿胀。膜增厚和变薄是术中穿孔的危险因素。从小手术对窦膜的影响角度来看，小穿孔和假性囊肿可能并非上颌窦提升术的禁忌证。
