鼻内镜下脑棉辅助上颌窦真菌球清除术

目的 探讨鼻内镜下中鼻道上颌窦开窗术治疗上颌窦真菌球的一种技术改良-脑棉辅助清除的方法及其在临床中的应用价值。方法 16例上颌窦真菌球患者均采用鼻内镜下中鼻道上颌窦开窗术，分成脑棉技术组和非脑棉技术组。比较两组病例的手术时间和术后并发症及复发情况。结果 脑棉技术组6例，手术时间40~ 60min，平均(51±9)min，术后定期鼻内镜随访12个月，无残留或复发，主诉无不适。非脑棉技术组10例，有5例同时采用下鼻道开窗辅助，手术时间30~100min，平均(74±25)min，术后鼻内镜随访6 ~20个月，无残留或复发，术后有2例发生鼻腔粘连，于门诊处理。结论 脑棉技术能够辅助鼻内镜下中鼻道上颌窦开窗术完全清除上颌窦真菌球，该法操作简单、器械易得、损伤小、术后效果好，值得在临床中推广。

Brain cotton technique in endoscopic middle meatus antrostomy for removing maxillary fungus ball

Objective To investigate the effect of brain cotton technique in endoscopic middle meatus antrostomy for removing maxillary fungus ball. Methods 16 cases of maxillary fungusl balls were randomly divided into two groups: the brain cotton technique group and the non brain cotton technique group. The surgical time, post-operative complications and recurrence were compared between the two groups. Results 6 patients were enrolled in the brain cotton group and were performed operations from 40min to 60min with an average of 51min. Followed up by endoscopy in 12 months, no one had post operative complications or recurrence. 10 patients were enrolled in the non brain cotton technique group, 5 of whom had inferior meatus antrostomy and were performed operations from 30min to 100min with an average of 74min. Followed up by endoscopy for 6 months to 20 months, no one had recurrence. 2 patients had nasal adhesion and were cured by endoscopy in outpatient. Conclusion Maxillary fungus ball can be cured just through endoscopic middle meatus antrostomy assisted by the brain cotton technique. It is simple and convenient with little damage and good result and can be widely applied in clinic.