鼻唇囊腫的新手術法－經鼻內視鏡造袋術

背景：鼻唇囊腫為長於鼻面部的良性、非牙胎生囊腫。傳統上，均以經唇下切開方式將囊腫完全切除為主要的治療法。本文首度提出以更簡單、有效的經鼻內視鏡造袋術來治療鼻唇囊腫。方法：自1996年4月至1999年10月，本科以經鼻內視鏡造袋術治療23名鼻唇囊腫患者。其中男4名、女19名，平均年齡49歲。絕大多數患者在局部麻醉下接受手術。首先以鼻竇手術所使用的鐮刀及鼻甲剪等器械由鼻腔進入，切開並移除囊腫頂壁形成一造口，之後在鼻內視鏡的導引下，配合咬合鉗及鼻甲剪擴大造口，並修整其切緣，使造口的鼻腔黏膜與囊腫內襯上皮對齊，即完成手術。術後僅以凡士林纱條簡單填塞2至3天。追蹤期2至42個月，平均19個月。結果：總共23例，25側鼻唇囊腫以此法治療。除1側因囊腫太小無法順利完成造袋術外，其餘24側均獲成功。手術多在10至20分鐘內完成。術後回診的內視鏡及影像學檢查，可見一通暢的造口位於前鼻側底部，而且原有的囊腫部位已被一含氣的竇狀腔所取代。追蹤至今均無積液、造口阻塞或囊腫復發的現象。結論：以經鼻內視鏡造袋術治療鼻唇囊腫所提供的不僅是一種新的手術理念，更是一種實用、簡便且有效的手術方式。

關鍵字

內視鏡的；造袋術；鼻唇囊腫；經鼻的

並列摘要

BACKGROUND:Nasolabial cysr is a nonodontogenic cyst located entirely within the soft tissues of the upper lip and nasal vestibule. Most of the previous reports advised to remove the cyst surgically through a transoral aublabial incision. This article offers a new, simple and minimally invasive surgical procedure regarding the treatment of nasolabial cysts. METHODS:From April 1996 through October 1999, we performed the transnasal endo-scopic marsupialization on 23 consecutive patients(25 sides)with nasolabial cysts. There were 19 women and 4 men and ages ranged from 18 to 78 with a mean age of 49. Under local anesthesia, we transnasally sacrified the dome of the cyst with a sickle knife and scissors and then widened the opening of the cyst with a cup forceps under the guidance of a nasoendoscope. Finally, we matched the cut edges of the nasal floor mucosa and epithelial lining of the cyst as possible as we could. After surgery, the nose was loosely packed. These patients were followed up from 2 to 42 months with a mean of 19 months. RESULTS:This procedure was successfully performed in all but one patient whose cyst was too small to identify the lumen. The whole surgical technique was usually finished within 10 to 20 minutes, and no postopeative morbidity such as bleeding, nasofacial swelling or wound infection occurred. The newly created sinus with a persistent opening assessed by postoperative nasoendoscopic and radiological studies was satisfactory. Until now, we observed there was no evidence of obstruction of the opening or recurrence. CONCLUSIONS:Based on our results, we believe that the transnasal endoscopic marsupi-alization is a practical, simple and effective modality that should be considered when treating the nasolabial cysts.

並列關鍵字

endoscopic ； marsupialization ； nasolabial cyst ； transnasal

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鼻唇囊腫的新手術法－經鼻內視鏡造袋術

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