[摘要]目的：探讨颊侧局部口腔黏膜瓣、颊脂垫修补治疗口腔上颌窦瘘的临床效果差异。方法：本研究采用随机单盲临床试验，选取北京市第六医院2015年6月-2023年1月收治的80例口腔上颌窦瘘患者，随机将其分为A组和B组，各40例，A组患者采用功能性鼻内镜下局部口腔黏膜瓣修复手术治疗，B组患者采用功能性鼻内镜下颊脂垫修补手术治疗，比较两组患者修复治疗前后的口腔健康影响程度量表（OHIP-14）评分、鼻部功能差异。结果：治疗后，B组患者的影响发音、明显的疼痛感、吃东西不舒服、感觉不自在、对饮食不满意、进餐中途需要停止、影响患者休息评分均低于A组患者，差异均具有统计学意义（P＜0.05）；在治疗1个月、3个月后，B组患者的鼻部功能VAS评分均低于A组患者，差异均具有统计学意义（P＜0.05）。结论：颊侧局部口腔黏膜瓣、颊脂垫修补治疗口腔上颌窦瘘的效果均较好，但是功能性鼻内镜下颊脂垫修补手术治疗患者术后功能恢复更好。

[关键词]颊侧；黏膜瓣；颊脂垫；口腔上颌窦瘘；口腔健康；修复

[中图分类号]R782.2" " [文献标志码]A" " [文章编号]1008-6455（2025）06-0069-04

Comparison of the Therapeutic Effects of Local Oral Mucosal Flaps on the Buccal Side and Buccal Lipid Pads in Repairing Oral Maxillary Sinus Fistulas

MA Yucong1， JIAO Pengchao2， GUO Liangrong3， YANG Wenpeng4

（ 1.Department of" Stomatology， Beijing Sixth Hospital， Beijing 100007， China; 2. Department of" Stomatology， Beijing Miyun District Hospital， Beijing 10049， China; 3. Department of Otorhinolaryngology， Aerospace Central Hospital， Beijing 100007， China; 4. Department of Stomatology， Aerospace Central Hospital， Beijing 100007， China ）

Abstract： Objective" Exploring the clinical differences in the treatment of maxillary sinus fistula with local buccal mucosal flap and buccal fat pad repair. Methods" This study used a randomized single blind clinical trial to select 80 patients with oral maxillary sinus fistula admitted to Beijing Sixth Hospital from June 2015 to January 2023. They were randomly divided into Group A and Group B， with 40 patients in each group. Group A patients underwent functional endoscopic local oral mucosal flap repair surgery， while Group B patients underwent functional endoscopic cheek fat pad repair surgery， Compare the differences in oral health impact scale （OHIP-14） scores and nasal function between two groups of patients before and after repair treatment. Results" After treatment， patients in Group B had lower scores than those in Group A in terms of pronunciation， significant pain， discomfort in eating， feeling uncomfortable， dissatisfaction with diet， need to stop during meals， and impact on rest， with statistical significance （P＜0.05）. After 1 and 3 months of treatment， the VAS scores of nasal function in Group B patients were lower than those in Group A patients， and the differences were statistically significant （P＜0.05）. Conclusion" The effect of buccal local oral mucosa flap and buccal fat pad repair is better in the treatment of oral and maxillary sinus fistula， but functional nasal endoscopic buccal fat pad repair surgery is better.

Key words： buccal side; mucosal flap; cheek fat pad; oral maxillary sinus fistula; oral health; repair

口腔上颌窦瘘是一种常见的口腔疾病，其特点是口腔黏膜与上颌窦之间的异常通道形成[1-3]。该疾病常常导致上颌窦内的细菌感染，引起慢性鼻窦炎、鼻塞、面部疼痛等临床症状。目前，手术修复是治疗口腔上颌窦瘘的主要方法之一[4-5]。然而，传统的修复方法存在一些局限性，如手术创伤大、术后并发症多等问题。因此，寻找一种更有效、安全的修复方法对于提高口腔上颌窦瘘的治疗效果具有重要意义。……