牙源性鼻窦炎的微创手术治疗方法

D. Avetikov, I. Yatsenko, V. N. Нavryliev, V. V. Aipert
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引用次数: 0

摘要

今天,在所有上颌窦炎病例中,牙源性鼻窦炎(OS)发生率高达40%。与此同时,OS的发病率也在增加。这得益于一些因素,如晚期医疗、诊断能力的提高、牙科手术数量的增加,特别是随着上颌窦粘膜底的提升而进行的种植干预。工作的目的是开发一个最佳的,节省手术的选择,应该导致持久的恢复患者牙源性鼻窦炎。5年来,在监测和治疗下,有58例高血压患者,年龄从20岁到65岁。其中42例为拔牙手术并发症导致鼻窦下壁穿孔所致。在42例观察到的牙源性鼻窦炎(OS)患者中,有1例患者不需要对上颌窦病变进行根治性手术。所有患者均通过最小的手术干预实现了骨结构、上颌窦粘膜、鼻腔和口腔的持续恢复。本文作者认为,对于多发性硬化症,没有证据表明根治性手术治疗多发性硬化症,手术干预应保留器官。只有并发炎性骨髓炎、眼眶和颅内并发症的OS才可以例外。多发性硬化症患者应在颌面科就诊,并义务咨询耳鼻喉科医生,耳鼻喉科医生比颌面外科医生更了解多发性硬化症的病理过程特点。此外,在手术中应该使用一套保守的措施,这将有助于确保发炎的鼻窦得到有效治疗。如果有机会选择最佳的保留干预措施,可以使OS患者获得最佳的稳定恢复。
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MINIMALLY INVASIVE METHODOLOGY FOR SURGICAL TREATMENT OF ODONTOGENIC SINUSITIS
Today, odontogenic sinusitis (OS) occurs in up to 40% of cases among all maxillary sinusitis. At the same time there is an increase in the incidence of OS. This is facilitated by factors such as late medical treatment, improved diagnostic capabilities, an increase in number of dental and especially implantation interventions with the lifting of mucous floor of maxillary sinus. The aim of work was to develop an optimal, sparing surgical option that should lead to a lasting recovery of patients with odontogenic sinusitis. For 5 years, under supervision and treatment, there were 58 patients with hypertension from the age of 20 to 65 years. In 42 of them, the cause of development of exhaust gas was a complication of the tooth extraction operation, which led to perforation of the lower wall of the sinus. In one case out of 42 observed patients with odontogenic sinusitis (OS), the patient did not need to undergo radical surgery on the maxillary sinus lesions. All patients managed to achieve a sustained recovery with minimal surgical intervention, both in bone structures, and in the mucous membrane of the maxillary sinus (MS), nasal cavity and oral cavity. The authors of the article believe that at in case of OS, there is no evidence for radical surgery on MS, and surgical intervention should be organ-preserving. An exception can be made only for cases of OS that is complicated by inflammatory osteomyelitis, orbital and intracranial complications. Patients with OS should be treated in maxillo-facial departments with obligatory consultation of the otorhinolaryngologist, who knows the features of pathological process in MS better than the maxillofacial surgeon. In addition, in OS one should use a set of conservative measures that will help to ensure the compete treatment of the inflamed sinus. Having the opportunity to choose the optimal sparing variant of intervention, one can achieve optimal and steady recovery of patients with OS.
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