上颌骨拉通 "技术:用内窥镜辅助微创方法治疗伴有上颌骨浸润的鼻中隔新形成。

IF 0.8 Q4 DENTISTRY, ORAL SURGERY & MEDICINE
Paolo Priore, Filippo Giovannetti, Andrea Battisti, Danilo Di Giorgio, Marco Della Monaca, Ingrid Raponi, Andrea Cassoni, Valentino Valentini
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引用次数: 0

摘要

研究设计目的:描述并验证一种手术技术:鼻腔内上颌骨切除术同时切除鼻中隔是一种罕见的手术;而保留鼻骨和牙槽嵴完整性的手术则更为罕见。传统上,这类手术需要在鼻外侧切开术的基础上进行经口联合手术。我们描述了一种内窥镜经鼻-经口联合方法,用于治疗累及硬腭的鼻中隔恶性肿瘤:方法:采用经鼻-经口内窥镜方法切除了4名患者的鼻中隔恶性肿瘤。使用角度为 0° 和 30° 的 4 毫米光学镜片,将鼻中隔从乙状结肠中游离出来,并通过硬腭向下牵拉鼻中隔,将其与硬腭同位切除:结果:4 名患者中,2 人接受了鼻中隔软骨肉瘤完全切除术,1 人接受了鼻窦未分化癌切除术,1 人接受了黏液表皮样癌切除术。在两个病例中,为了恢复鼻腔和口腔之间的分离,保留了腭粘膜并进行了重新定位。其余两例病例接受了硬腭完全切除术,其中一例使用颞肌瓣重建腭部,另一例使用闭孔器重建腭部。没有发生感染。所有四例患者都进行了乙状结肠部分切除术。平均住院时间为 5 天。所有患者在平均 4 年(2-7 年)的随访后均未再发病:结论:我们的新方法可对延伸至上颚的鼻中隔恶性肿瘤进行微创切除。我们的上颌拉通技术是治疗鼻中隔恶性病变的一种有价值的新手术方法;唯一的缺点是内窥镜手术的学习曲线很陡峭。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The 'Maxillary Pull-through' Technique: A Minimally Invasive Endoscopic-Assisted Approach to Nasal Septum Neoformations with Maxillary Bone Infiltration.

Study design: Description and validation of a surgical technique.

Objective: En-bloc maxillectomy with removal of the nasal septum is a rare procedure; preservation of the nasal bones and integrity of the alveolar ridge is even rarer. These procedures traditionally required a combined transfacial-transoral approach based on lateral rhinotomy. We describe a combined endoscopic transnasal-transoral approach for treatment of nasal septal malignancies that involve the hard palate.

Methods: Excision of malignant tumours arising from the nasal septum was achieved in 4 patients using a transnasal-transoral endoscopic approach. Using 4-mm optics angled at 0° and 30°, the septum was freed from the ethmoid and removed en-bloc with the hard palate, by pulling the septum down through the hard palate.

Results: Of the 4 patients, 2 underwent complete removal of septal chondrosarcomas, one removal of a sinonasal undifferentiated carcinoma and one removal of a mucoepidermoid carcinoma. In two cases, the palatal mucosa was spared and repositioned to restore separation between the nose and oral cavity. The remaining two cases underwent complete resection of the hard palate; one palate was reconstructed using a pedicled temporalis muscle flap and the other by employing an obturator. No infection was encountered. Partial ethmoidectomy was performed in all four cases. The mean hospital stay was 5 days. All patients are free of disease after a mean follow-up of 4 years (range: 2-7 years).

Conclusions: Our new approach allows for minimally invasive resection of nasal septal malignancies that extend to the palate. Our maxillary pull-through technique is a valuable new surgical procedure for malignant pathologies of the nasal septum; the only drawback is that endoscopic surgery has a steep learning curve.

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来源期刊
Craniomaxillofacial Trauma & Reconstruction
Craniomaxillofacial Trauma & Reconstruction DENTISTRY, ORAL SURGERY & MEDICINE-
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