内镜下经鼻前庭翻瓣入路行鼻前庭囊肿切除术的疗效观察
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摘要
目的:观察内镜下经鼻前庭翻瓣入路行鼻前庭囊肿切除术的临床疗效及术后随访情况。方法:将45例鼻前庭囊肿患者随机分为2个组:鼻前庭翻瓣组(25例)和唇龈沟入路组(20例)。比较2组患者的手术时间、术中出血量、伤口愈合时间、术后局部麻木感、术后1周内进食不便或疼痛、术后伤口疼痛程度及面部肿胀程度和随访情况。结果:(1)2组患者手术均顺利,随访1～3年,平均1.5年,均无复发;(2)鼻前庭翻瓣组患者术中出血量、伤口愈合时间、术后上唇局部麻木感发生率、术后1周内进食不便或进食伤口疼痛加重发生率与唇龈沟入路组相比均差异有统计学意义(P<0.05);鼻前庭翻瓣组患者手术时间与唇龈沟入路组相比差异无统计学意义(P>0.05);(3)鼻前庭翻瓣组术后伤口疼痛程度及面部肿胀程度均明显轻于唇龈沟入路组(P<0.05)。结论:内镜下经鼻前庭翻瓣入路行鼻前庭囊肿切除手术方法具有术中出血少、伤口愈合时间短、术后局部反应轻、痛苦小、术后复发率低且不增加手术时间等优点。
Objective:To observe the clinical Effect of intranasal excision under open the nasal vestibular flap on nasal vestibular cyst under nasal endoscopy.Method:Forty-five patients with nasal vestibular cyst were randomly divided into two groups:nasal vestibule flap group(n=25)and labial gingival crevicular approach group(n=20).Comparison of two groups of patients with operation time,intraoperative blood loss,wound healing time,postoperative local numbness or pain,1 week after eating the inconvenience,the degree of postoperative wound pain,postoperative facial swelling degree were compared between the two groups.Result:(1)The operation of the two groups was successful,and all patients were not relapse followed-up for 1-3 years and averaged 1.5 years.(2)Compared with labial gingival crevicular groove approach group,the amount of bleeding,wound healing time,postoperative upper lip numbness in local incidence,one week after operation of eating or the incidence rate of eating inconvenience pain aggravate in nasal vestibular double flap group with were all statistically significant(P<0.05).The operation time of the two groups were not statistically significant(P>0.05).(3)The degree of pain and swelling of the face in the nasal vestibule flap group were significantly lighter than that of the labial gingival crevicular approach group(P<0.05).Conclusion:Endoscopic resection of nasal vestibular cyst through nasal vestibule flap approach has advantages in less intraoperative bleeding,shorter wound healing time,much less postoperative local reaction,less pain and lower postoperative recurrence rate,and does not increase operative time.
Objective:To observe the clinical Effect of intranasal excision under open the nasal vestibular flap on nasal vestibular cyst under nasal endoscopy.Method:Forty-five patients with nasal vestibular cyst were randomly divided into two groups:nasal vestibule flap group(n=25)and labial gingival crevicular approach group(n=20).Comparison of two groups of patients with operation time,intraoperative blood loss,wound healing time,postoperative local numbness or pain,1 week after eating the inconvenience,the degree of postoperative wound pain,postoperative facial swelling degree were compared between the two groups.Result:(1)The operation of the two groups was successful,and all patients were not relapse followed-up for 1-3 years and averaged 1.5 years.(2)Compared with labial gingival crevicular groove approach group,the amount of bleeding,wound healing time,postoperative upper lip numbness in local incidence,one week after operation of eating or the incidence rate of eating inconvenience pain aggravate in nasal vestibular double flap group with were all statistically significant(P<0.05).The operation time of the two groups were not statistically significant(P>0.05).(3)The degree of pain and swelling of the face in the nasal vestibule flap group were significantly lighter than that of the labial gingival crevicular approach group(P<0.05).Conclusion:Endoscopic resection of nasal vestibular cyst through nasal vestibule flap approach has advantages in less intraoperative bleeding,shorter wound healing time,much less postoperative local reaction,less pain and lower postoperative recurrence rate,and does not increase operative time.
引文
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[4]吴兴宇,佘文胜,周林.鼻前庭囊肿揭盖术与唇龈沟径路切除术的疗效比较[J].武汉大学学报(医学版),2015,36(5):754-756.
[5]陈子松,林琳,覃多录.内镜下经鼻前庭切除鼻前庭囊肿[J].中华耳鼻咽喉头颈外科杂志,2004,39(10):627-628.
[6]黄选兆,汪吉宝,孔维佳.实用耳鼻咽喉头颈外科学[M].北京:人民卫生出版社,2011:93-94.
[7]李福军,杨蓓蓓,王海军.鼻前庭囊肿发生机制的探讨[J].临床耳鼻咽喉头颈外科杂志,2007,21(2):82-83.
[8]SHEIKH A B,CHIN O Y,FANG C H,et al.Nasolabial cysts:a systematic review of 3ll cases[J].Laryngoscope,2016,126:60-66.
[9]郝凯飞,闫朝晖,陶树东.内镜下经鼻行鼻前庭囊肿完整剥除术的疗效观察[J].中华耳鼻咽喉头颈外科杂志,2017,52(5):361-364.
[2]王涛,杨钦泰,刘贤,等.经鼻内镜改良鼻前庭囊肿切除的临床研究[J].中国耳鼻咽喉头颈外科,2012,19(7):375-377.
[3]汤建芬,耿曼英,张慧.鼻前庭囊肿两种手术方式的比较[J].临床耳鼻咽喉头颈外科杂志,2014,28(8):570-571.
[4]吴兴宇,佘文胜,周林.鼻前庭囊肿揭盖术与唇龈沟径路切除术的疗效比较[J].武汉大学学报(医学版),2015,36(5):754-756.
[5]陈子松,林琳,覃多录.内镜下经鼻前庭切除鼻前庭囊肿[J].中华耳鼻咽喉头颈外科杂志,2004,39(10):627-628.
[6]黄选兆,汪吉宝,孔维佳.实用耳鼻咽喉头颈外科学[M].北京:人民卫生出版社,2011:93-94.
[7]李福军,杨蓓蓓,王海军.鼻前庭囊肿发生机制的探讨[J].临床耳鼻咽喉头颈外科杂志,2007,21(2):82-83.
[8]SHEIKH A B,CHIN O Y,FANG C H,et al.Nasolabial cysts:a systematic review of 3ll cases[J].Laryngoscope,2016,126:60-66.
[9]郝凯飞,闫朝晖,陶树东.内镜下经鼻行鼻前庭囊肿完整剥除术的疗效观察[J].中华耳鼻咽喉头颈外科杂志,2017,52(5):361-364.