首诊眼科的真菌性鼻窦炎的影像解剖学特点

目的　分析以眼部症状为主的真菌性鼻窦炎的影像解剖学特征及临床表现。 方法　选取2008年1月~2018年1月三家医院耳鼻咽喉头颈外科收治的真菌性鼻窦炎患者285例中首诊于眼科的20例患者的临床资料，分析其特征及临床误诊的原因。 结果　该20例首诊于眼科的病例其病变主要位于筛窦3例，蝶窦2例，上颌窦合并筛窦3例，筛窦合并蝶窦8例，上颌窦合并筛窦、蝶窦4例，眼部症状主要为单侧眼胀痛、视力下降、视野改变、面部疼痛及头痛。 结论　以单侧眼部胀痛及视力改变就诊于眼科的患者，应考虑真菌性鼻窦炎的可能，及时给予鼻窦CT检查后转耳鼻咽喉科进行治疗。

Imaging anatomical characteristics and clinical manifestations of fungal sinusitis in the first consultation ophthalmology

Objective　To analyze the imaging anatomical and clinical characteristics of fungal sinusitis, which is dominated by eye symptoms.　Methods　Two hundred and eighty-five patients with fungal sinusitis admitted to the department of otolaryngology and neck surgery in three hospitals from January 2008 to January 2018 were selected, and the clinical data of 20 patients in the first consultation ophthalmology were collected, the characteristics and causes of clinical misdiagnosis were analyzed.　Results　The lesions of the 20 cases first consultation ophthalmology were mainly located in sieve sinus (3 cases), sphenoid sinus (2 cases), maxillary sinus combined with ethmoid sinus (3 cases), 8 cases of ethmoid sinus combined with sphenoid sinus, maxillary sinus combined with ethmoid sinus and sphenoid sinus (4 cases). The ocular symptoms mainly included unilateral swelling pain, diminution of vision, vision change, facial pain and headache.　Conclusions　Patients admitted to the department of ophthalmology with unilateral swelling pain and diminution of vision should consider the possibility of fungal sinusitis and then should be transferred to department of otolaryngology for treatment after sinus CT examination.