鼻内镜手术治疗真菌性鼻窦炎

目的 探讨鼻内镜治疗真菌性鼻窦炎的临床效果及与鼻腔解剖异常之间的关系。方法 回顾性分析经病理学确诊的31例真菌性鼻窦炎（fungal Sinustis，FS）的鼻内镜检查和CT扫描的病变特征、临床表现以及鼻内镜下鼻窦开放术式治疗真菌性鼻窦炎的效果。结果 CT扫描或鼻内镜检查显示31例患者鼻腔均有不同程度的解剖异常或病变及窦腔内病灶；全部病例病理学检查均发现真菌孢子、菌丝和黏膜炎症，临床分型均属非侵袭性FS，其中5例为变应性真菌性鼻窦炎（allergic fungal sinusitis，AFS）。术后随访2-4年，治愈27例（87．1％），显效2例（6．5％），无效2例（6．5％）。结论 鼻腔解剖异常及局部病变与FS关系密切。

Management of fungal sinusitis with endoscopic sinus surgery

OBJECTIVE To investigate the treatingeffects of endoscopic sinus surgery for fungal sinusitisand its relationship between the abnormality of anatomyand fungal sinusitis. METHODS The histopathologicalobservation,clinical manifestation features,nasal sinusendoscopy examination and sinus CT scan character-istics of 31 cases with fungal sinusitis which confirmedby pathological examination were analyzedretrospectively. RESULTS All of the 31 cases werediagnosed as noninvasive fungal sinusitis by pathologi-cal examination and showed different extent abnormal-ity of nasal anatomy. Five of 31 cases were finally diag-nosed as allergic fungal sinusitis. All the patients werefollowed-up for 2 to 4 years. Twenty seven cases werecured (curative rate was 87.1 %)and 2 cases showedapparent efficacy (6.5 %),while 2 cases showed ineffi-cacy (6.5 %). CONCLUSION There were close rela-tionship between nasal anatomy abnormality and the patho-genesis of fungal sinusitis. The endoscopic sinus surgerywas the main method for management of fungal sinusitis.