手术治疗上颌骨药物相关性颌骨坏死对伴发上颌窦炎转归的影响

doi:10.13701/j.cnki.kqyxyj.2026.08.011

口腔医学研究 ›› 2026, Vol. 42 ›› Issue (8): 702-707.DOI: 10.13701/j.cnki.kqyxyj.2026.08.011

手术治疗上颌骨药物相关性颌骨坏死对伴发上颌窦炎转归的影响

许慧霞, 寇家豪, 何金媛, 孙国文^*

南京大学医学院附属口腔医院,南京市口腔医院口腔颌面外科,南京大学口腔医学研究所江苏南京 210008

收稿日期:2025-11-21 出版日期:2026-08-28 发布日期:2026-08-17
通讯作者: ^*孙国文,E-mail:238957@sina.com
作者简介:许慧霞(1998~ ),女,浙江台州人,硕士在读,住院医师,研究方向:口腔颌面外科。
基金资助:
南京市卫生科技发展专项资金项目(编号:YKK22183)

Impact of Surgical Treatment for Medication-related Osteonecrosis of the Maxilla on Outcome of Concomitant Maxillary Sinusitis

XU Huixia, KOU Jiahao, HE Jinyuan, SUN Guowen^*

Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Institute of Stomatology, Nanjing University, Nanjing 210008, China

Received:2025-11-21 Online:2026-08-28 Published:2026-08-17

摘要/Abstract

摘要： 目的: 评估手术治疗上颌骨药物相关性颌骨坏死 (medication-related osteonecrosis of the jaws,MRONJ)后,其伴发上颌窦炎的转归情况。方法: 收集南京大学医学院附属口腔医院(南京市口腔医院)口腔颌面外科一病区2013年1月~2025年8月就诊的上颌骨MRONJ合并上颌窦炎患者的临床资料,共纳入31例患者。回顾其临床基本特征、手术过程、随访期间组织愈合情况、疼痛缓解情况及上颌窦炎症变化。结果: 术后,96.77%例(30/31)患者创口完全愈合,随访期内未观察到组织坏死、创面感染、MRONJ复发等情况。1例患者随访期间出现伤口裂开。45.16%例(14/31)患者上颌窦炎症消失,41.94%例(13/31)患者上颌窦炎症等级明显下降,12.90%例(4/31)患者上颌窦炎症未得到改善。结论: 通过术中彻底去除死骨,保留残余上颌窦窦腔黏膜,冲洗窦腔,良好封闭口腔上颌窦交通及围术期内使用抗生素这一治疗流程,可明显改善上颌骨MRONJ及其合并的上颌窦炎症,极大提升患者的生活质量。

Abstract: Objective: To evaluate the outcomes of concomitant maxillary sinusitis following surgical treatment for medication-related osteonecrosis of the maxilla. Methods: Clinical data of patients with maxillary medication-related osteonecrosis of the jaws (MRONJ) complicated by maxillary sinusitis who were treated in the First Ward of Oral and Maxillofacial Surgery, Affiliated Stomatological Hospital of Nanjing Medical University (Nanjing Stomatological Hospital) from January 2013 to August 2025 were collected. A total of 31 patients were enrolled. Their basic clinical characteristics, surgical procedures, tissue healing status, pain relief, and changes in maxillary sinus inflammation during follow-up were analyzed retrospectively. Results: Postoperatively, 30/31 patients (96.77%) achieved complete wound healing, and no complications including tissue necrosis, wound infection, or MRONJ recurrence were observed during follow-up. However, wound dehiscence occurred in 1 patient during follow-up. Regarding maxillary sinusitis: it resolved in 14/31 cases (45.16%), the inflammation grade decreased significantly in 13/31 cases (41.94%), and no improvement was noted in 4/31 cases (12.90%). Conclusion: The treatment protocol, which involves thorough sequestrectomy during surgery, preservation of residual maxillary sinus mucosa, sinus irrigation, effective closure of the oroantral communication, and perioperative antibiotic use, can significantly improve maxillary MRONJ and its concomitant maxillary sinusitis, thereby greatly enhancing patients' quality of life.

Key words: medication-related osteonecrosis of the jaws, maxillary sinusitis, maxillary sinus mucosa, buccal fat pad flap, antibiotics

许慧霞, 寇家豪, 何金媛, 孙国文. 手术治疗上颌骨药物相关性颌骨坏死对伴发上颌窦炎转归的影响[J]. 口腔医学研究, 2026, 42(8): 702-707.

XU Huixia, KOU Jiahao, HE Jinyuan, SUN Guowen. Impact of Surgical Treatment for Medication-related Osteonecrosis of the Maxilla on Outcome of Concomitant Maxillary Sinusitis[J]. Journal of Oral Science Research, 2026, 42(8): 702-707.

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手术治疗上颌骨药物相关性颌骨坏死对伴发上颌窦炎转归的影响

Impact of Surgical Treatment for Medication-related Osteonecrosis of the Maxilla on Outcome of Concomitant Maxillary Sinusitis

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