鼻腔鼻窦真菌病35例报告

目的:探讨鼻腔、鼻窦真菌病的临床特征、诊断和治疗。方法:根据病变范围和程度采用不同术式,非侵袭型采用上颌窦根治术或鼻窦内窥镜术,侵袭型采用扩大范围的鼻窦根治术,术后辅以抗真菌药治疗。结果:非侵袭型26例,其中25例经不同术式一次治愈;侵袭型9例,其中7例经不同术式一次治愈,1例虽经4次手术,终因病变广泛未能有效控制,5个月后死亡。结论:①CT对该类疾病的诊断有重要价值,病理学检查是确诊的依据。②手术是根本的治疗手段,无论哪种类型,均须彻底清除病灶,充分开放受累的鼻窦,对病变广泛的侵袭型还须扩大手术切除范围。

Noninvasive and invasive naso-sinus fungus:35 cases report

Objective;To study the clinical features,diagnosis and management of nose and nasal sinuses fungus. Method: Different manner of surgical procedure was taken according to the areas and degree of pathological changes. The patients with noninvasive fungus were treated with radical maxillary sinusotomy (cald-well-Luc operation) or endoscopic sinus surgery. The patients with invasive form were undergone by the sinusotomy of enlarging areas,and combined with a postoperatively antifungal therapy. Result; Twenty-six patients were involved in noninvasive fungus, and 25 cases in them were cured in single surgery through different manner. Nine patients were in invasive one, and 7 in them were also cured by single surgery in different manner. One patient with invasive fungus died 5 months postoperatively for extensive area and noneffective treatment although four surgical excisions were done. Conclusion: CT scan is very important in their diagnosis, and the histopathology leads to identification of the fungus. Surgical removal is a radical kind of treatment. It is essential to excise and open entirely the involved sinus cavity whatever type,and to enlarge areas for the extensive invasive fungus.