Clinical Analysis Of Two Surgical Paths Under Nasal Endoscope For The Treatment Of Benign Lesions Of Maxillary Sinus

ObjectiveTo explore the application value and scope of the nasal endoscope and the combined middle and lower nasal canal approach in order to better guide clinical work.MethodsThe retrospective study was conducted between October 2016 and December2018 in 60 patients with benign maxillofacial sinus lesions who underwent pericarpal pericarpal indwelling under the nose endoscope and combined medial and inferior nasal entry under the nose.Group A was a group of 30 patients with percutaneous pericarpal indwelling surgery,including 14 cases of maxillary papilloma(IP)(3 cases of recurrence)and 8 cases of maxillary polyps.3 cases of maxillary sinus cyst,2 cases of maxillary sinus hemorrhage necrotic polyp(HNNP),and 2 cases of maxillary posterior nostril polyp(ACP).2 cases,fungal upper maxillary sinus(fengitis),Frungitis,Frungitis.Group B was a group of 30 patients undergoing nasal endoscopic middle nasal canal combined with lower nasal canal double-track surgery,including 3 cases of overturning papilloma of the maxillary sinus,9 cases of maxillary sinus polyp,2cases of maxillary sinus cyst,and 1 case of maxillary sinus bleeding necrotic polyp,and 11 cases of maxillary nostriate polyp.Four cases of fungal infection of maxillary sinus.The operation was carried out by means of aero-static compound anesthesia,and the lesion range,operation time,bleeding volume,hospitalization time,postoperative complications and recurrence rate were recorded respectively in two groups of samples.ResultsIn group A patients,the attachment sites were located in the medial wall,anterior wall,anterior fossa and alveolar fossa of maxillary sinus.In group B patients,the attachment of the pathological foundation involved the lateral wall,the lower wall,theupper wall,and many parts near the maxillary sinus mouth.The outpatient follow-up period was 3 to 12 months,the surgical time of Group A patients was 60 to 150 min,the hospitalization time was 5 to 12 days,the bleeding volume was 30 to 120 ml,the average surgical time was 110 minutes,and the average hospitalization time was 7.3days.The average bleeding volume was 75.8 ML.There was no recurrence in 30 patients.After operation,the epithelium was exfoliated,and the shape of the lower turbinate was good.The surgical time of patients in group B ranged from 50 to 135 min,the hospitalization time ranged from 4 to 13 days,the average surgical time was105 min,the average hospitalization time was 7.5 days,the average bleeding amount was 30 to 120 ml,and the average bleeding amount was 74.7 ML.One of the IP patients relapsed,and there was no recurrence during the follow-up period after repeated operation of PLRA under the nasal endoscope.Postoperative observation showed no obvious complications.ConclusionSurgical treatment of benign lesions of maxillary sinuses under nasal endoscope is safe,the trauma is small,and the surgical field is wide.It can completely remove the lesions and retain the tear canal and lower turbinate,which has high clinical value.PLRA is suitable for patients with upper maxillary sinus varus papilloma or recurrence in the medial wall of the maxillary sinus,the anterior wall,the pre-tear crypt,the alveolar crypt and the Krouse stage of stage 3.Under the nasal endoscope,the middle and lower nasal canal combined with the track can treat some of the refractory benign lesions of the maxillary sinus,such as lesions involving the lateral wall,the lower wall,the upper wall,and many parts near the maxillary sinus mouth.