FESS术后两性霉素B鼻窦冲洗治疗真菌球型鼻窦炎的疗效观察

目的 观察功能性鼻内镜手术(FESS)术后两性霉素B(AmB)鼻窦冲洗治疗真菌球型鼻窦炎(FBS)的临床疗效.方法 选取2019年6月～2021年5月期间本院收治的50例行FESS的FBS患者,根据治疗方法不同,将患者分为治疗组和对照组每组25例,术后治疗组(n=25)予200μg/ml AmB行鼻窦内冲洗,对照组(n...     

Treatment of allergic fungal sinusitis: A comparison trial of postoperative immunotherapy with specific fungal antigens

Objective: To determine the effect of immunotherapy (IT) with fungal antigens on clinical outcome in patients with allergic fungal sinusitis (AFS). Study Design: Prospective case control. Methods: In this comparison study, 22 patients meeting the diagnostic criteria of allergic fungal sinusitis (AFS) were evaluated after a mean of 33 months' therapy. All received similar treatment consisting of endoscopic sinus surgery, corticosteroids, and antibiotics as needed for complicating purulent sinusitis. Eleven patients received postoperative immunotherapy (IT) with fungal and nonfungal antigens to which sensitivity had been demonstrated, while the remaining 11 received no immunotherapy. Results: The effect of IT was to significantly improve patient outcome as assessed objectively by an AFS endoscopic mucosal staging system (P < .001) and a sinusitis-specific quality-of-life scale, the Chronic Sinusitis Survey (P = .002). In addition, IT was shown to reduce reliance on systemic (P < .001) and topical nasal (P = .043) corticosteroid therapy to control disease. Follow-up was similar in the two groups and was not a determinant of differences in outcome (P = .7). Conclusions: Results from this study indicate that specific IT with fungal antigens improves patient outcome in AFS. Laryngoscope, 108:1623–1627, 1998     

中医序贯疗法联合FESS治疗慢性鼻窦炎的临床研究

目的观察中医序贯疗法联合功能性内镜鼻窦手术(FESS)治疗慢性鼻窦炎的临床疗效。方法将符合纳入条件的80例慢性鼻窦炎Ⅱ型患者,常规行FESS,术后按1:1随机分为对照组及治疗组,比较两组治疗前、治疗后3月、治疗后6月症状体征积分、鼻黏膜纤毛传输速率指标的差异。结果两组患者症状体征积分、鼻黏膜纤毛传输速率(MTR)治疗后3月、治疗后6月与治疗前比较差异均有显著性(P<0.05)、治疗后6月与治疗后3月比较差异有显著性(P<0.05),两组间治疗后3月、治疗后6月比较差异有显著性(P<0.05);治疗组与对照组疗效相比,差异均有显著性(P<0.05),治疗组疗效优于对照组。结论中医序贯治疗能促进鼻窦炎术后黏膜上皮化、有效预防术后复发。     

A rare case of Rosai-Dorfman disease of the paranasal sinuses

An unusual case of a 6-year-old male child presenting with a history of bilateral nasal obstruction of 3 years duration is reported. Endoscopic surgery was performed and the specimen sent for histopathological examination. The report revealed the surprise diagnosis of Rosai-Dorfman disease. This case of isolated extranodal involvement (paranasal sinuses) by this disease is presented and the literature available reviewed.     

Trends in the management of pediatric chronic sinusitis: survey of the American Society of Pediatric Otolaryngology

BACKGROUND: The management of chronic sinusitis (CS) in children has yet to be fully elucidated. The objective of this study is to assess practice trends within the pediatric otolaryngology community for the management of children with CS. METHODS: A multiple choice survey of the members of the American Society of Pediatric Otolaryngology (ASPO) was performed to assess for various factors related to the management of CS in children. RESULTS: A total of 175 ASPO members responded to the survey. The majority of respondents initially treat patients medically with oral antibiotics (95%), topical steroids (90%), and nasal saline sprays (68%). Fifty-five percent performed adenoidectomy as part of the treatment of CS, with 81% performing the operation before endoscopic sinus surgery (ESS). Compared with 3 years before the survey, 47% of respondents performed approximately the same number of ESS cases, whereas 35% reported doing fewer cases annually. Seventy-two percent of practitioners do not routinely perform a second-look surgery. CONCLUSIONS: The majority of pediatric otolaryngologists use oral antibiotics, nasal steroids, and saline lavage, and will perform adenoidectomy when managing patients with CS. More than a third of pediatric otolaryngologists are using more stringent criteria for surgery and performing less extensive surgery than 3 years before the survey. Surgical outcomes for CS do not appear to have changed over the past 3 years.