中华耳鼻咽喉头颈外科杂志
中華耳鼻嚥喉頭頸外科雜誌
중화이비인후두경외과잡지
CHINESE JOURNAL OF OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY
2012年
9期
764-766
,共3页
李树华%石洪金%吴大海%史春海
李樹華%石洪金%吳大海%史春海
리수화%석홍금%오대해%사춘해
鼻息肉%上颌窦%囊肿%内窥镜检查%耳鼻喉外科手术
鼻息肉%上頜竇%囊腫%內窺鏡檢查%耳鼻喉外科手術
비식육%상합두%낭종%내규경검사%이비후외과수술
Nasal polyps%Maxillary sinus%Cysts%Endoscopy%Otorhinolaryngologic surgical procedures
目的 通过对临床病例的系统研究,探讨上颌窦后鼻孔息肉的起源.方法 对26例上颌窦后鼻孔息肉患者进行系统临床研究,包括术前鼻内镜检查、冠状位和轴位CT扫描观察、术中鼻内镜下观察后鼻孔息肉与上颌窦内病变的关系、切除标本的大体观察和组织病理学检查等,综合分析所有资料,讨论上颌窦后鼻孔息肉的起源及形成机制.结果 术前鼻内镜检查中17例可以明确观察到息肉根蒂部出自上颌窦口或副口,CT扫描中19例可以明确观察到中鼻道后鼻孔软组织影与上颌窦内软组织影联系密切.术中追踪息肉起源发现23例患者上颌窦内病变为囊肿,后鼻孔息肉根蒂部与上颌窦囊肿关系密切,一般为根蒂经上颌窦口与囊肿相连,将息肉连同囊肿一并切除后,发现息肉表面黏膜与囊肿的囊壁相延续,息肉本身成为囊壁增生肥厚的一部分.结论 上颌窦后鼻孔息肉多起源于同侧上颌窦囊肿,其发病机制推测为上颌窦内逐渐增大的上颌窦囊肿最终自上颌窦口膨出到中鼻道并逐渐增大,并逐渐突向后鼻孔,最终形成上颌窦后鼻孔息肉.
目的 通過對臨床病例的繫統研究,探討上頜竇後鼻孔息肉的起源.方法 對26例上頜竇後鼻孔息肉患者進行繫統臨床研究,包括術前鼻內鏡檢查、冠狀位和軸位CT掃描觀察、術中鼻內鏡下觀察後鼻孔息肉與上頜竇內病變的關繫、切除標本的大體觀察和組織病理學檢查等,綜閤分析所有資料,討論上頜竇後鼻孔息肉的起源及形成機製.結果 術前鼻內鏡檢查中17例可以明確觀察到息肉根蒂部齣自上頜竇口或副口,CT掃描中19例可以明確觀察到中鼻道後鼻孔軟組織影與上頜竇內軟組織影聯繫密切.術中追蹤息肉起源髮現23例患者上頜竇內病變為囊腫,後鼻孔息肉根蒂部與上頜竇囊腫關繫密切,一般為根蒂經上頜竇口與囊腫相連,將息肉連同囊腫一併切除後,髮現息肉錶麵黏膜與囊腫的囊壁相延續,息肉本身成為囊壁增生肥厚的一部分.結論 上頜竇後鼻孔息肉多起源于同側上頜竇囊腫,其髮病機製推測為上頜竇內逐漸增大的上頜竇囊腫最終自上頜竇口膨齣到中鼻道併逐漸增大,併逐漸突嚮後鼻孔,最終形成上頜竇後鼻孔息肉.
목적 통과대림상병례적계통연구,탐토상합두후비공식육적기원.방법 대26례상합두후비공식육환자진행계통림상연구,포괄술전비내경검사、관상위화축위CT소묘관찰、술중비내경하관찰후비공식육여상합두내병변적관계、절제표본적대체관찰화조직병이학검사등,종합분석소유자료,토론상합두후비공식육적기원급형성궤제.결과 술전비내경검사중17례가이명학관찰도식육근체부출자상합두구혹부구,CT소묘중19례가이명학관찰도중비도후비공연조직영여상합두내연조직영련계밀절.술중추종식육기원발현23례환자상합두내병변위낭종,후비공식육근체부여상합두낭종관계밀절,일반위근체경상합두구여낭종상련,장식육련동낭종일병절제후,발현식육표면점막여낭종적낭벽상연속,식육본신성위낭벽증생비후적일부분.결론 상합두후비공식육다기원우동측상합두낭종,기발병궤제추측위상합두내축점증대적상합두낭종최종자상합두구팽출도중비도병축점증대,병축점돌향후비공,최종형성상합두후비공식육.
Objective To explore the origin and etiopathogenesis of antrochoanal polyp (ACP)based on the clinical data.Methods Twenty-six patients with ACP were included in the study.All the ACP patients were documented by preoperative endoscopy and computer tomographic (CT) scans.All patients were treated under endonasal endoscopic surgery.The relationship between polyp in middle meatus and lesions in the antrum was observed during the surgery.Following surgical removal,the polyps and lesions in the antrum were studied under macroscopy and microscopy.Results Among 26 cases with ACP,17 cases were confirmed by preoperative endoscopic examination that polyp originating from antrum ostium,19 cases showed intimate relationship between the polyp and antrum lesions in CT scan,and 23 cases were found that the polyp originating from the antrum cyst.The pedicle of polyp connected the cyst through autrum ostium,and the polyp existed as a part of capsule wall.Conclusion Based on the data obtained,it is tempting to suggest that the ACP mainly develops from antral cyst,an increase in pressure in cyst forced capsule wall to herniate to middle meatus through the antral ostium,and the continuous herniation and hyperplasy leading to the formation of ACP.
