鼻内镜下蝶窦开放术治疗真菌性蝶窦炎32例临床体会

目的 探讨鼻内镜下蝶窦开放术治疗真菌性蝶窦炎的技术要点和疗效分析。方法 回顾分析2006年6月～2009年6月在我院确诊为真菌性蝶窦炎患者32例的临床资料，总结其影像学特征及临床表现，并分析手术技术要点及治疗效果。结果 鼻窦CT显示蝶窦腔内可见明显的高密度斑点或条块状钙化影，是本病特征性的表现。真菌性蝶窦炎临床表现以头痛、涕中带血为主。术后随访12~18个月,患者症状明显好转，无鼻腔黏连、复发等发生。结论 鼻窦CT检查可提高真菌性蝶窦炎的诊断率，鼻内镜手术具有视野清晰、创伤小、出血少、安全性高等优点，符合功能性手术的理念，是治疗真菌性蝶窦炎的首选术式。

Endoscopic surgery for fungal sphenoid sinusitis

Objective To investigate the operative skill and therapeutic effect of sinus surgery under nasal endoscope for fungal sphenoid sinusitis.　Methods A total of 32 cases of fungal sphenoid sinusitis were enrolled from June 2006 to June 2009. The image features and clinical manifestations were summarized, and the points of operation and therapeutic effectiveness were analyzed.　Results CT scanning showed apparent reflection of calcification with high density of spots or strips in the lumen of the sphenoid sinus, which were the specific features. The main clinical manifestation included headache and bloody nasal discharge. All these cases treated under nasal endoscope were cured without nasal adhesion and relapse during a follow-up period of 12-18 months after the surgery. Conclusions Sinus CT examination can improve the diagnostic rate of fungal sphenoid sinusitis. Nasal endoscopic surgery is a preferred procedure for the treatment of fungal sphenoid sinusitis, with advantages such as clear surgical vision field，minimal invasive, much less bleeding and high security.