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目的:探讨采用内镜辅助下等离子射频消融手术治疗牙源性上颌窦炎的效果。方法:回顾性分析35例牙源性上颌窦炎患者的资料。其中采用内镜辅助下等离子低温射频治疗患者23例,手术从患侧上颌窦前壁开窗,鼻内镜经中鼻道开口或在开窗处进路,在内镜下探查炎症病灶的具体部位,在去除病灶牙的同时,应用等离子低温射频对上颌窦内病变黏膜部分进行多点消融。其他12例患者采用柯-陆手术治疗,比较2种方法的治疗效果。结果:采用柯-陆手术患者平均住院天数11d,12例患者术后面颊肿胀明显,7例出现面部麻木,6例出现牙疼痛。采用内镜辅助下等离子射频消融手术患者平均住院5d,且未出现上述并发症。内镜辅助射频治疗组术后3个月鼻道窦口完全恢复通畅。35例患者随访3个月时未见复发。结论:与柯-陆手术相比,采用内镜辅助下等离子低温射频消融手术治疗牙源性上颌窦炎在去除病灶的同时,减少了上颌窦黏膜和骨质的损伤,减少患者住院时间,利于术后恢复,临床疗效肯定。
Objective: To investigate the effect of endoscopic assisted radiofrequency catheter ablation on odontogenic maxillary sinusitis. Methods: A retrospective analysis of 35 patients with odontogenic maxillary sinusitis data. Among them, 23 patients underwent endoscopic-assisted plasma cryogenic radiofrequency ablation were used to open the window of the anterior wall of the maxillary sinus in the affected side. The nasal endoscope was guided through the opening of the middle nasal canal or the fenestration to probe the specific inflammatory lesions under endoscopy Site, remove the lesion at the same time, the application of plasma cryogenic radio frequency lesions of the maxillary sinus mucosa part of the multi-point ablation. The other 12 patients were treated with Ke-Lu surgery, the treatment of two methods were compared. Results: The average duration of hospital stay in Ke-Lu operation was 11 days. The postoperative cheek swelling in 12 patients was obvious. Facial numbness was found in 7 patients and tooth pain was found in 6 patients. Endoscopic assisted radiofrequency ablation surgery in patients with an average of 5 days hospitalization, and the above complications did not occur. Endoscopic assisted radiofrequency treatment group 3 months after the sinus ostium completely recovered. 35 patients were followed up for 3 months, no recurrence. CONCLUSIONS: Compared with Ke-Lu operation, endoscopic-assisted plasma cryogenic radiofrequency ablation for the treatment of odontogenic maxillary sinusitis can reduce mucosal injury and bone remnant in the maxillary sinus and reduce hospitalization time, Postoperative recovery, clinical efficacy certainly.