背景:内镜下改良的内侧上颌窦切除术(MMM)和泪前入路(PLA)是两种常规的上颌窦内镜入路,当通过中孔吻合术的入路不足时。然而,文献中没有数据比较两种手术的结局和并发症情况,以确定哪种方法更优.
目的:比较PLA和MMM的发病途径。
方法:对2009年至2023年接受MMM或PLA治疗的所有连续成年患者进行回顾性队列研究。主要结果是鼻出血的发展,感觉异常,泪腺损伤,术后至少3个月内的医源性鼻窦功能障碍。
结果:39例(44侧)接受了PLA,96例(96侧)接受了MMM。感觉异常率之间没有统计学上的显着差异(9.1%vs14.6%,p=0.367)或延长的感觉异常(2.3%vs5.2%,p=0.426),医源性上颌窦功能障碍(2.3%vs5.2%,p=0.426)或需要去除的粘连(4.5%vs4.2%,p=0.918)。在我们的研究中,任一手臂均未出现泪液或鼻腔狭窄。
结论:根据我们的数据,鼻内镜下改良内侧上颌骨切除术和泪前入路都是同样安全的入路,它们都有各自的好处。
BACKGROUND: The endoscopic modified medial maxillectomy (MMM) and prelacrimal approach (PLA) are two routinely performed endoscopic approaches to the maxillary sinus when access via a middle meatal antrostomy is insufficient. However, there is no data in the literature that has compared outcomes and complication profile between the two procedures to determine which approach is superior.
OBJECTIVE: To compare the approach related morbidity of PLA and MMM.
METHODS: A retrospective cohort study of all consecutive adult patients undergoing either MMM or PLA from 2009 to 2023 were identified. The primary outcome was development of epistaxis, paraesthesia, lacrimal injury, iatrogenic sinus dysfunction within a minimum of 3 months post-operative follow up.
RESULTS: 39 patients (44 sides) underwent PLA and 96 (96 sides) underwent MMM. There were no statistically significant differences between the rates of paraesthesia (9.1 % vs 14.6 %, p = 0.367) or prolonged paraesthesia (2.3 % vs 5.2 %, p = 0.426), iatrogenic maxillary sinus dysfunction (2.3 % vs 5.2 %, p = 0.426) or adhesions requiring removal (4.5 % vs 4.2 %, p = 0.918). No cases of epiphora or nasal cavity stenosis occurred in either arm in our study.
CONCLUSIONS: According to our data, the endoscopic modified medial maxillectomy and prelacrimal approach are both equally safe approaches with their own benefits to access.