内窥镜下改良上颌窦根治术治疗上颌窦真菌病

目的探讨内窥镜辅助下改良上颌窦根治术治疗非侵袭性上颌窦真菌病的疗效。方法采用4 mm Storz 30°鼻内窥镜经唇龈沟小切口入路清除上颌窦内病灶,再经鼻腔切除同侧钩突,扩大上颌窦自然口,术中、术后分别用5%聚维酮碘溶液(PVP-I)冲洗窦腔,全身和局部均不用抗真菌药。结果所有病例术后3,6个月经鼻内窥镜检查,上颌窦窦腔内黏膜光滑,无异常分泌物,自然窦口引流好。随访6个月~5年,患者症状均消失,鼻腔无分泌物,鼻窦CT复查无复发。结论采用鼻内窥镜辅助下小切口改良上颌窦根治术治疗非侵袭性上颌窦真菌病,清除病灶彻底,不损伤鼻腔、鼻窦正常生理功能,保证上颌窦正常的引流功能,复发率低,疗效好。

Treatment of non-invasive maxillary mycosis with modified radical maxillary operation under nasal endoscopy

Objective: To explore the effect of modified radical operation with nasal endoscopy on non-invade the maxillary sinus mycosis. Methods: 95 cases of non-invade the maxillary sinus mycosis were treated with modified radical operation with nasal endoscopy. The maxillary cavity was cleaned through a small open in the anterior wall and then irrigated with solution of 5% PVP-I in and irrigated again after operation. Results: In the follow up from 6 months to 5 years, all cases were cured. Conclusion: With the modified radical maxillary sinusectomy under endoscopy, the disease tissue can be quite cleaned out and the function of nasal cavity and maxillary sinus can be preserved as many as possible. The recrudescence rate is low and the curative effect is fine.