鼻内镜下治疗非侵袭性真菌性鼻-鼻窦炎的术式选择与疗效

目的探讨鼻内镜手术与传统术式结合治疗非侵袭性真菌性鼻-鼻窦炎的疗效。方法对我科2003年6月～2009年6月有完整随访资料的接受鼻内镜手术治疗的58例非侵袭性真菌性鼻-鼻窦炎患者的临床资料进行分析。其中采用单纯鼻内镜手术32例,鼻内镜联合改良柯-陆术式11例,鼻内镜联合下鼻道开窗15例,并对所有患者术后情况进行随访。结果随访1年以上,仅3例手术后复发,其余55例在随访期内均未见复发。结论鼻内镜手术是治疗非侵袭性真菌性鼻-鼻窦炎安全且有效的手段,可基本完整保留鼻腔、鼻窦正常的解剖结构。彻底清除真菌团块、术后定期随访是治疗成功的关键。

Selection of surgical approaches and efficacy of endoscopic surgery for noninvasive fungal rhinosinusitis

Objective To evaluate the effect of endoscopic surgery plus traditional procedure in the management of noninvasive fungal rhinosinusitis.Methods The clinical data of 58 patients treated with endoscopic surgery in our department from June 2003 to June 2009 were retrospectively analysed.Among these patients,32 cases were treated by endoscopic surgery only;11 cases were treated by endoscopic surgery plus modifided Caldwell-Luc technique;15 cases were treated by endoscopic plus inferior meatus antrostomy approach.All patients were followed up postoperativelly.Results All patients were followed up one year.Among them,55 cases had no recurrence,whereas three cases recurred during the follow-up period.Conclusion Endoscopic surgery offers a safe and effective method for noninvasive fungal rhinosinusitis with minimal invasiveness.It can maintain the basic struture of the nose and sinus.Thorough removal of fungal mass and regular follow-up are the key points for success.