Department of Otolaryngology, Centro Hospitalar Universitario de Santo Antanio, Porto, Portugal; Faculdade de Ciencias da Saude, Universidade da Beira Interior, Covilha, Portugal.
Faculdade de Ciencias da Saude, Universidade da Beira Interior, Covilha, Portugal.
Rhinology. 2024 Jun 1;62(3):271-286. doi: 10.4193/Rhin23.296.
The prelacrimal window approach (PLWA) is a minimally invasive surgical technique that has been proposed as an alternative to the traditional approaches to access the maxillary sinus.
A systematic review with meta-analysis was performed following PRISMA guidelines and identified 368 articles for initial review of which 14 (610 participants) met the criteria for meta-analysis. Four databases, including PubMed, Google Scholar, Web of Science and Scopus, were searched to identify relevant articles. Two independent reviewers conducted the eligibility assessment for the included studies. Methodology quality and risk of bias were evaluated by New Castle Ottawa scale. The outcomes assessed were recurrence of the pathology, postoperative morbidity including epiphora, dry nose, facial, gingival numbness, epistaxis or local infection.
The present data suggest a significant reduction in the recurrence rate of maxillary sinus pathology following PLWA when compared to conventional surgery (endoscopic medial maxillectomy, endoscopic sinus surgery and the Caldwell-Luc operation). The rates of epiphora, facial or gingival numbness, epistaxis or infection requiring intervention, were not significantly different between the procedures.
Maxillary sinus pathology can be effectively treated using the PLWA technique, as it has been shown to result in a lower recurrence rate compared to conventional surgeries.
鼻泪前窗入路（PLWA）是一种微创外科技术，已被提议作为传统上颌窦入路的替代方法。
按照 PRISMA 指南进行系统评价和荟萃分析，最初共检索到 368 篇文章，其中 14 篇（610 名参与者）符合荟萃分析的标准。通过检索 PubMed、Google Scholar、Web of Science 和 Scopus 四个数据库，确定了相关文章。两名独立的评审员对纳入研究进行了合格性评估。采用纽卡斯尔-渥太华量表评估方法学质量和偏倚风险。评估的结果包括病理复发、术后并发症（溢泪、干鼻、面部、牙龈麻木、鼻出血或局部感染）。
与传统手术（内镜下内侧上颌窦切除术、内镜鼻窦手术和 Caldwell-Luc 手术）相比，PLWA 术后上颌窦病理复发率显著降低。溢泪、面部或牙龈麻木、需要干预的鼻出血或感染的发生率在手术之间无显著差异。
PLWA 技术可有效治疗上颌窦病变，因为与传统手术相比，其复发率较低。
