摘要
背景：副鼻竇之黏液囊腫是指因囊腫內黏液狀分泌物積存，造成副鼻竇腔擴大的疾病，其誘因包括感染、囊狀纖維化、手術、外傷及腫瘤等，一般常見於額竇及篩竇。上頜竇之病灶則較少見，且多與手術或外傷有關。故提出有關上頜竇術後囊腫之臨床經驗。 方法：本文乃收集台北榮總耳鼻喉部1986年10月至1998年2月間22名被診斷為上頜竇手術後囊腫之患者，分析其過去病史、臨床表現、電腦斷層攝影檢查結果及治療方法。 結果：其中男性16名、女性6名，平均45歲，過去皆有因副鼻竇炎接受Caldwell-Luc氏手術之病史，時間間隔平均21.55年。大多數患者以臉頰紅腫或疼痛來表現，而電腦斷層攝影均顯示上頜竇內充滿囊狀壁包圍的低密度均質性物質，周圍骨壁受到壓迫而變薄，且囊腫從原先上頜竇造口處向外擴張，造成附近軟組織發炎。再次接受Caldwell-Luc氏手術之病理報告顯示，大部分為單純呼吸上皮，少數混合扁平上皮。 結論：由本文得知，上頜竇術後囊腫的診斷須藉助病史的詢問、臨床表現及影像學檢查，並與惡性腫瘤作鑑別診斷，而目前治療仍偏向採取傳統Caldwell-Luc氏手術作一造口引流，並避免復發。
並列摘要
Background: Paranasal sinuses mucoceles are defined as expanded sinus cavities with accumulation of mucoid secretions and most cases are are related to infection, trauma, cystic fibrosis, space-occupying lesion and surgery. Frontal sinus is the most common involved location and maxillary sinus mucoceles are relatively rare. In the paper, we present our experience about postoperative maxillary cyst. Methods: From 186 to 1998, 22 patients with postoperative maxillary cysts were diagnosed and treated at our department. Past history, clinical manifestation, physical examination, radiological examination, operative finding and pathological examination were all assessed. Results: The patients included 16 men and 6women. The mean age was 44.77 years. Each patient received Caldwell-Luc operation for chronic paranasal sinusitis and the average period was 21.55 years. CT scan revealed a cystic lesion filling the maxillary sinus and extending through the previous antrostomy into the face or gingivea. Respiratory epithelium was mentioned in most pathological reports. Conclusions: Postoperative maxillary cysts were diagnosed by past history, clinical manifestation. Radiological examination and pathological report. Revised Caldwell-Luc operation was the most appropriate treatment.
延伸閱讀
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