■上颌骨牙囊肿的标准治疗方法是手术摘除术,拔牙。如果囊肿累及上颌窦,使用Caldwell-Luc方法。如果是大囊肿,它的有袋化是为了减少骨缺损而进行的,然后摘除和拔除牙齿。
■这是一例上颌大的滤泡性牙囊肿,上颌窦内有18颗异位牙,在我们单位接受治疗。
■我们决定执行多门户访问,口内内窥镜辅助技术;口内入路已被执行,但比常规的口内方法更少拆除,穿过上颌窦的前壁,已经被病变侵蚀了。病变很大,占据整个上颌腔。出于这个原因,仅通过口内途径,要完全切除病变是极其困难的。内窥镜辅助技术与口内途径相结合。病变延伸至上颌口。这不允许通过经典的内窥镜方法到达口。鼻内内镜入路均用于摘除囊肿,粘附于OMC(骨瘤复合体)的眶底和软组织,并恢复上颌窦的生理引流。
■我们决定进行口内和内窥镜联合入路,以完全切除囊性病变,而不是非常拆除和利用已经由大囊肿引起的骨侵蚀。
UNASSIGNED: The standard treatment for a dentigerous cyst of maxilla is a surgical enucleation, the extraction of the tooth. In the case of cysts involving the maxillary sinus, a Caldwell-Luc approach is used. In case of large cysts, its marsupialization is carried out in order to reduce the bone defect, followed by enucleation and extraction of the tooth.
UNASSIGNED: This is a case of a large follicular dentigerous cyst of upper jaw with 18 ectopic tooth within the maxillary sinus, treated in our Unit.
UNASSIGNED: We decided to perform a multi-portal access, the intraoral endoscopic-assisted technique; an intraoral approach has been performed, but less demolishing than the routine intraoral approach, through the anterior wall of the maxillary sinus, already eroded by the lesion. The lesion was very large, occupying the entire maxillary cavity. For this reason, by means of the intraoral approach alone, it was extremely difficult to remove the lesion in its entirety. The endoscopic-assisted technique was combined with intraoral approach. The lesion extended to the maxillary ostium. This did not allow to reach the ostium through the classic endoscopic approach. Endonasal endoscopic access was used both to enucleate the cyst, that was adherent to the orbital floor and soft tissues of the OMC (osteomeatal complex), and to restore the physiological drainage of the maxillary sinus.
UNASSIGNED: We decided to perform a combined intraoral and endoscopic approach to allow a complete excision of the cystic lesion, without being very demolishing and taking advantage of the bone erosion already caused by the large cyst.