摘要
目的探讨功能性鼻内镜术结合牙科程序治疗牙源性上颌窦炎的疗效评价。方法回顾536例单侧牙源性上颌窦病变患者临床资料,在实施功能性鼻内镜手术及牙科治疗术后的第2、4、12、24周运用Lund-Kennedy内镜评分对上颌窦黏膜形态进行评估,CT测量上颌窦黏膜术后各观测点的厚度。结果术后第4、12周真菌性牙源性上颌窦炎病变黏膜形态评分分别为(3.31±0.54)、(3.62±0.23)分,慢性上颌窦炎和上颌窦囊肿病变黏膜形态评分分别为(1.73±0.79)、(2.13±0.51)分(第4周)和(1.69±0.31)、(1.92±0.41)(第12周),与真菌性上颌窦炎差异有统计学意义(χ^(2)=42.72,P=0.036<0.05;χ^(2)=41.01,P=0.032<0.05),余差异均无统计学意义(P>0.05);三种类型牙源性上颌窦炎黏膜均在FESS术后明显变薄,真菌性上颌窦炎12周(4.87±0.51mm)和24周(3.07±0.62mm)与慢性上颌窦炎的12周(3.59±0.50)、24周(1.79±0.65mm)及上颌窦囊肿的12周(3.62±0.51mm)、24周(1.82±0.39mm)差异有统计学意义。结论功能性鼻内镜手术结合牙科治疗对牙源性上颌窦炎有良好的疗效评价;真菌性牙源性上颌窦炎与与其他类型相比黏膜恢复相对不佳。
Objective To evaluate the efficacy of functional endoscopic sinus surgery(FESS)combined with dental treatment for odontogenic maxillary sinusitis.Methods A total of 536 patients with unilateralodontogenic maxillary sinusitis were reviewed.The morphology of maxillary sinus mucosa was evaluated by Lund-Kennedy endoscopic score at the 2,4,12 and 24 weeks after FESS and dental treatment,while the thickness of maxillary sinus mucosa was measured through CT scan.Results At the 4 and 12 weeks after FESS,the mucosal morphological scores of fungal odontogenic maxillary sinusitis were(3.31±0.54)and(3.62±0.23),chronic maxillary sinusitis and maxillary sinus cyst were(1.73±0.79)and(1.69±0.31),and maxillary sinuscyst were(2.31±0.51)and(1.92±0.41),which had statistical significance compared with fungal maxillary sinusitis(χ^(2)=42.72,P=0.036<0.05;χ^(2)=41.01,P=0.032<0.05).The other differences were not statistically significant(P>0.05).The mucosa of the three types of odontogenic maxillary sinusitis was significantly thinner after FESS.There were significant differences between fungal maxillary sinusitis at 12 weeks(4.87±0.51mm)and 24 weeks(3.07±0.62mm)and chronic maxillary sinusitis at 12 weeks(3.59±0.50),24 weeks(1.79±0.65mm)and maxillary sinus cyst at 12 weeks(3.62±0.51mm)and 24 weeks(1.82±0.39mm).Conclusion FESS combined with dental treatment has a good effect on odontogenic maxillary sinusitis.Mucosal recovery of fungal odontogenic maxillary sinusitis is relatively poor compared with other types.
作者
浦益萍
钱文涛
赵影颖
吴晴伟
PU Yiping;QIAN Wentao;ZHAO Yingying;WU Qingwei(Department of Oral Surgery,Shanghai Ninth People’s Hospital,Shanghai Jiao Tong University School of Medicine,College of Stomatology,Shanghai Jiao Tong University,National Center for Stomatology,National Clinical Research Center for Oral Diseases,Shanghai Key Laboratory of Stomatology,Shanghai,200011,China)
出处
《中国中西医结合耳鼻咽喉科杂志》
2022年第3期189-192,共4页
Chinese Journal of Otorhinolaryngology in Integrative Medicine
基金
上海交通大学医学院附属第九人民医院临床研究型MDT项目201701017。
关键词
牙源性上颌窦炎
真菌性上颌窦炎
功能性鼻内镜
odontogenic maxillary sinusitis
fungal maxillary sinusitis
functional nasal endoscopy
