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Minimally Invasive Maxillary Sinus Approach

机译:微创上颌窦入路

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Abstract Maxillary sinus (MS) opening is one of the most common surgical procedures. For rhinological situations endonasal sinus intervention is more preferable. Microscopes and endoscopes can be used endonasaly, intervention can be performed trans middle meatus or rarely via inferior meatus with artificial window formation. Last years number of patients with dental indications for MS surgery highly increases. Most of these patients have no rhinological complains. CT examination made prior to tooth implantations and sinus lifting often detected pathological changes in maxillary sinus floor. These changes can be not significant for rhinology but important for implantology. In such cases, trans middle meatus approach is traumatic and technically difficult. Also this surgical strategy leads to destruction of physiological function of osteomeatal unit. Last 7 years we prefer inferiour meatus temporary approach without artificial window formation for maxillary sinus endoscopic surgery. Intervention can be performed in most cases under local anesthesia. After Hassner valve is identified, area of incision can be chosen and be performed with elevator. Osteo mucosal flap preparation depends on situation with prevention of lacrimal pathways damage and bony walls retraction. For maxillary sinus examination and removal of pathological tissues we use different angled endoscopes, or with changeable view directions. Required angle of instruments depends on situation. At the end of surgical procedure flap can be returned back to close gap of temporary approach and if necessary mucosa can be fixed by sutures. Postoperative period and care is easy, surgery can be performed in the office. Our experience shows the advantages of this approach as one of minimally traumatic methods of MS surgery.Der Erstautor gibt keinen Interessenkonflikt an.
机译:摘要上颌窦(MS)开口是最常见的外科手术之一。对于鼻腔疾病,鼻窦介入治疗更为可取。显微镜和内窥镜可用于鼻内镜,可通过中鼻道进行干预,或很少通过下鼻道进行人工成形。近年来,具有MS手术牙科适应症的患者数量大大增加。这些患者大多数没有流变学上的不适。牙齿植入和窦提升之前进行的CT检查通常可以检测到上颌窦底的病理变化。这些变化对流变学而言并不重要,但对植入学而言则很重要。在这种情况下,跨中鼻道入路是创伤性的并且技术上困难。同样,这种手术策略也导致骨肉单位生理功能的破坏。最近7年,对于上颌窦内窥镜手术,我们更喜欢采用不带人工窗形成的下鼻道临时手术。在大多数情况下,可以在局部麻醉下进行干预。识别Hassner阀后,可以选择切口区域并通过升降机执行。骨粘膜瓣的准备取决于防止泪道损伤和骨壁回缩的情况。对于上颌窦检查和病理组织切除,我们使用不同角度的内窥镜或可改变的观察方向。所需的仪器角度取决于情况。在外科手术结束时,皮瓣可退回至暂时性间隙,并在必要时通过缝线固定粘膜。术后时期而且护理很容易,可以在办公室进行手术。我们的经验表明,这种方法作为MS手术的最小创伤方法之一具有优势。

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