摘要
目的探讨并总结面颈部牙源性瘘的临床特征及诊疗新进展。方法回顾性分析诊治的4例面颈部牙源性瘘的临床资料，其中瘘口位于颏部1例，鼻旁区3例，均由根尖周感染引起。临床症状以面颈部皮肤反复肿胀及破溃流脓为主。本组患者皆行手术切除瘘管，术中发现瘘管延至患牙，1例行患牙拔除，3例行根管治疗。结果本组患者随访2—24个月，瘘VI愈合，无复发病例。结论面颈部牙源性瘘在临床中常被忽略，对于以面颈部反复感染为主诉的病例应考虑到牙源性的可能。其诊断常依靠影像学检查及术中发现，治疗应彻底清除感染灶，可达到治愈。
Objective To investigate the chnlcal characterlstlcs, dlagnosls and treatment ot cervlcotaclai cutaneous sinus tract of odontogenic origin. Methods Clinical data of 4 patients with cervicofacial cutaneous sinus tract of odontogenic origin receiving treatment in our department from March 1993 to March 2014 were analyzed retrospectively. As for the location of orificium fistulae, 1 was on the chin and 3 were on the paranasal region. The fistulae were caused by periapical periodontitis in all 4 cases. The main clinical symptoms were cervicofacial cutaneous lesion with repeated swelling and drainage of pus. Sinus tracts were found to be originated from diseased tooth during surgery and therefore the finial diagnose was confirmed in all cases. Furthermore, extraction of infected tooth was applied to one case, and endodontic therapy to 3. Results All the patients were followed up for 2 to 24 months postoperatively. The orificium fistulae got healed up in all cases and no relapse occurred. Conclusions Cervicofacial cutaneous sinus tract of odontogenic origin is rare and usually misdiagnosed. Dental origin should be considered for repeated infection of cervicofacial region. The diagnosis depends on radiographic examination and surgical findings. Complete elimination of dental infection is essential for the treatment of this disease.
出处
《中国耳鼻咽喉颅底外科杂志》
CAS
2015年第2期96-98,103,共4页
Chinese Journal of Otorhinolaryngology-skull Base Surgery
基金
上海市卫生局中医处科研项目支持(2010J010A)
关键词
面颈部瘘
牙源性感染
窦道
Cervicofacial cutaneous sinus tract
Odontogenic infection
Fistula
