唇下进路面中部翻揭术在鼻部手术中的应用山西医学院第二附属医院（０３０００１）宋发全，张岑娜，庞桂芝，赵丽芬唇下进路面中部翻揭术治疗鼻腔、鼻窦、鼻咽口至颅底的良、恶性肿瘤的报道日益增多。我们自１９９０年底以来，采用此术式治疗双侧鼻腔、鼻窦病变２例，采用此术式的简化式治疗单侧病变５例，效果满意，现将手术方法及体会报告如下。临床资料７例中男４例，女３例；年龄９～５５岁。７例中２例为双侧鼻腔、鼻窦病变，作经典的面中部翻揭术，清除双侧鼻腔、上颌窦及筛窦病变。另５例仅单侧病变，包括４例鼻腔内翻性乳头状瘤，ｌ例上颌窦血管瘤侵犯筛窦、鼻腔，仅采用了简化式。手术方法１．患者仰卧垫肩，经口插管全麻，龈颊沟及鼻内切口浸润１：２００的副肾盐水。２．切口由４部组成：①作双侧Ｃａｌｄｗｅｌｌ－ｌｕｃ切口。内端在上唇系带处相连。深达骨面，然后剥离子紧贴骨面向上分离至眶下孔，保护眶下神经，暴露双侧梨状孔及上颌骨鼻棘。②双侧软骨间切口。在相当于鼻侧软骨与鼻翼软骨间沿皮肤与粘膜交界处作弧形切口，继之用剥离子伸到鼻侧软骨上面紧贴软骨向上小心分离鼻背软组织，使其与软骨和骨性鼻背分开，至鼻根部。③鼻小柱贯通切口。在相当于鼻中隔四方软骨和大翼软骨内侧 Lower lip into the pavement in the Department of laparotomy in nasal surgery in the Second Affiliated Hospital of Shanxi Medical College (030001) Song Faquan, Zhang Cenna, Pang Guizhi, Zhao Lifen into the pavement under the labial approach to the nasal cavity, nasal sinus, nasopharyngeal To the skull base of the growing number of reports of malignant tumors. We since the end of 1990, the use of this surgical treatment of bilateral nasal and sinus lesions in 2 cases, using this simplified treatment of unilateral disease in 5 cases, the results are satisfactory, the surgical methods and experience are reported as follows. Clinical data in 7 cases, 4 males and 3 females; aged 9 to 55 years. Two of the seven cases were bilateral nasal and sinus lesions. The classic midfacial ligation was performed to clear bilateral nasal cavity, maxillary sinus and ethmoid sinus lesions. The other 5 cases only unilateral lesions, including 4 cases of nasal inverted papilloma, l cases of maxillary sinus hemorrhage violations of the ethmoid sinus, nasal cavity, using only the simplified formula. Surgical methods Patients supine shoulder pads, oral intubation general anesthesia, gingival cheek groove and intranasal incision infiltration of 1: 200 of renal water. 2. Incision consists of 4 parts: ① for bilateral Caldwell-luc incision. The inner end is connected to the upper lip lace. Deep bone surface, and then stripping off the child close to the bone surface up to the infraorbital foramen to protect the infraorbital nerve, bilateral pyriform and exposed the maxillary nasal spines. ② bilateral cartilage incision. In the equivalent of the nasal cartilage and nasal alar cartilage along the skin and mucous membrane at the junction for arc incision, followed by peel extension to the nasal cartilage close to the cartilage upwards Be careful separation of the soft tissue of the nose back to cartilage and bony nose Back apart, to the nasal roots. ③ columectomy through the incision. In the equivalent of nasal septum cartilage and cartilage inside