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采用三维容积分析评估改良鼻内镜辅助鼻窦手术治疗上颌窦疾病的疗效

Treatment outcome of modified endoscopic assisted sinus surgery for treating maxillary sinus diseases with three dimensional volumetric analysis.

作者信息

Choi Sul Gi, Lee Won-Uk, Han Jeong Joon

机构信息

Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Research Institute, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.

Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.

出版信息

Sci Rep. 2024 Sep 16;14(1):21620. doi: 10.1038/s41598-024-72840-y.

DOI:10.1038/s41598-024-72840-y
PMID:39284919
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11405514/
Abstract

This retrospective study aimed to analyze volumetric changes of the maxillary sinus after modified endoscopic-assisted sinus surgery (MESS) and to assess short-term treatment outcomes. The volumes of the total maxillary sinus, aeration, and sinus pathology were calculated using computed tomography data obtained prior to surgery and six months after surgery. Postoperative radiological improvement was assessed using the Lund-Mackay score. Bone regeneration around the bony window was evaluated during plate removal. A total of 32 patients were evaluated. Compared with before surgery, air and sinus pathology volumes improved significantly (air, increase by 6.0 cm, p < 0.001; sinus pathology, decrease by 6.4 cm, p < 0.001). However, there was no statistically significant change in the total maxillary sinus volume after surgery. The preoperative Lund-Mackay score was 2.9, decreasing to 0.4 six months after surgery (p < 0.001). The only predictors of postoperative aeration rate and Lund-Mackay score were preoperative sinus pathology volume (p = 0.049) and Lund-Mackay score (p = 0.015), respectively. The continuity between the bony window and surrounding sinus wall was restored in all patients. The results of this study suggest that MESS can be a successful, effective, and minimally invasive surgical treatment option for treating maxillary sinus diseases.

摘要

这项回顾性研究旨在分析改良内镜辅助鼻窦手术（MESS）后上颌窦的容积变化，并评估短期治疗效果。利用手术前及术后6个月获得的计算机断层扫描数据计算上颌窦总体积、气腔及鼻窦病变的体积。采用Lund-Mackay评分评估术后影像学改善情况。在取出钢板时评估骨窗周围的骨再生情况。共评估了32例患者。与手术前相比，气腔和鼻窦病变体积有显著改善（气腔，增加6.0 cm，p<0.001；鼻窦病变，减少6.4 cm，p<0.001）。然而，术后上颌窦总体积无统计学显著变化。术前Lund-Mackay评分为2.9，术后6个月降至0.4（p<0.001）。术后气腔率和Lund-Mackay评分的唯一预测因素分别是术前鼻窦病变体积（p=0.049）和Lund-Mackay评分（p=0.015）。所有患者的骨窗与周围鼻窦壁之间的连续性均得以恢复。本研究结果表明，改良内镜辅助鼻窦手术可成为治疗上颌窦疾病的一种成功、有效且微创的手术治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/056c/11405514/01036471a6fa/41598_2024_72840_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/056c/11405514/5c965bce54dc/41598_2024_72840_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/056c/11405514/3baa615d0cc8/41598_2024_72840_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/056c/11405514/3eb16da1e9db/41598_2024_72840_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/056c/11405514/01036471a6fa/41598_2024_72840_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/056c/11405514/5c965bce54dc/41598_2024_72840_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/056c/11405514/3baa615d0cc8/41598_2024_72840_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/056c/11405514/3eb16da1e9db/41598_2024_72840_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/056c/11405514/01036471a6fa/41598_2024_72840_Fig4_HTML.jpg

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