鼻内镜手术治疗真菌球性鼻窦炎临床分析

目的探讨真菌球性鼻窦炎(非侵袭型真菌性鼻窦炎)的临床表现、诊断及治疗。方法总结本科2005年5月～2010年4月收治的52例真菌球性鼻窦炎的临床资料,分析其临床表现、CT表现、手术方法及疗效。结果全部病例术后6个月进行评价,治愈50例、无效2例。无效者均为未坚持规律复诊者,经再次手术,术后规律换药、冲洗,治愈。所有病例均随访1年以上,无复发。结论真菌球性鼻窦炎以上颌窦最好发,筛窦、蝶窦次之,额窦少见;单窦发病为主,也可逐渐累及一侧多窦,罕见双侧累及。鼻窦CT有助于早期诊断。手术彻底清除窦内病变组织,建立通畅的长期引流通道是治疗的关键。

Clinical analysis of nasal endoscopic operation for treatment of noninvasive fungal sinusitis

Objective To study the clinical manifestations, diagnosis and treatment of noninvasive fungal sinusitis. Methods Data of 52 patients with noninvasive fugal sinusitis admitted from May 2005 to April 2010 were summarized. The clinical manifestations, CT data, operation method and its curative effect was analyzed. Results Six months after the surgery, 50 cases were cured, 2 cases were not effective. All cases were followed up for more than one year with no recurrence occured. Conclusions Noninvasive fungal sinusitis frequently occurred in maxillary sinus, followed by etbmoid sinus and sphenoid sinus, rarely oceured in frontal sinus. It is a single sinus disease and can also gradually involve the multiple sinuses of the same side. Bilateral involvement was rarely seen. Sinus CT is an effective method for the diagnose. Complete removal of sinus lesions within the organization and the establishment of patency of the long-term drainage channel are the key points of the treatment. （Chin J Ophthalmol and Otorhinolaryngol,2012,12：303-305）