山东大学耳鼻喉眼学报 ›› 2014, Vol. 28 ›› Issue (6): 37-39.doi: 10.6040/j.issn.1673-3770.0.2013.336

• 论著 • 上一篇    下一篇

鼻内镜下真菌性上颌窦炎的治疗体会

董守豪1, 施清圆2, 王珍珍2, 庄建华1, 林加祥1, 廖志苏2   

  1. 1. 温州市鹿城区人民医院耳鼻咽喉科, 浙江 温州 325000;
    2. 温州医科大学附属第一医院耳鼻咽喉科, 浙江 温州 325000
  • 收稿日期:2013-11-26 发布日期:2014-12-16
  • 作者简介:董守豪. E-mail:38400781@qq.com

Endoscopic surgery for treating fungal maxillary sinusitis

DONG Shou-hao1, SHI Qing-yuan2, WANG Zhen-zhen2, ZHUANG Jian-hua1, LIN Jia-xiang1, LIAO Zhi-su2   

  1. 1. People's Hospital of Lucheng District, Wenzhou 325000, Zhejiang, China;
    2. The First Affiliated Hospital of Wenzhou Medical College, Wenzhou 325000, Zhejiang, China
  • Received:2013-11-26 Published:2014-12-16

摘要: 目的 探讨鼻内镜下中、下鼻道双径路与鼻内镜下中鼻道两种手术方式治疗真菌性上颌窦炎的疗效. 方法 40例真菌性上颌窦炎患者行鼻内镜下中、下鼻道上颌窦联合开窗术治疗(A组),53例采用鼻内镜下中鼻道开窗术治疗(B组).术后随访1~2年,定期行鼻窦冲洗及鼻内镜复查.根据1997年海口标准评定手术疗效.结果 A组治愈36例(90%),好转4例(10%),无效0例,有效率为100%;B组治愈45例(84.9%),好转1例(1.9%),无效及复发7例(13.2%),有效率为86.8%.两组有效率差异有统计学意义(χ2=5.713, P=0.018). 结论 鼻内镜下鼻窦术治疗真菌性上颌窦炎有效,可先行中鼻道开窗术,对真菌球不能彻底清除者,加用下鼻道开窗术治疗,可以达到理想的效果.

关键词: 真菌性上颌窦炎, 下鼻道开窗术, 鼻内镜鼻窦手术

Abstract: Objective To explore the treatment effect of middle and inferior antrostomies in the endoscopic and simple endoscopic sins surgery for fungus maxillary sinusitis. Methods 40 cases were treated with endoscopic surgery middle plus inferior antrostomies (A group), and 53 cases were treated with nasal endoscopic fenestration of middle meatus (B group). Based on the Haikou standard in accordance with 1997, the efficacy of the two groups was assessed. Results During a post-operative follow-up of 1 to 2 years, 36 cases were cured (90%) and 4 cases were improved (10%) in group A, while 45 cases were cured(84.9%), 1 case was improved(1.9%) and 7 cases were relapsed or had no effect. The difference was significant between the two groups (χ2=5.713, P=0.018). Conclusion Nasal endoscopic operation for fungus ball maxillary sinusitis is effective.

Key words: Fungal ball maxillary sinusitis, Endoscopic sinus surgery, Inferior meatus fenestration

中图分类号: 

  • R765.9
[1] 刘英, 赵春丽, 郑贵亮. 真菌球性上颌窦炎术后黏膜恢复的观察[J]. 山东大学耳鼻喉眼学报, 2007, 21(1):60-61,64. LIU Ying, ZHAO Chunli, ZHENG Guiliang. Postoperative mucosa recovery of fungal ball sinusitis[J]. J Otolaryngol Ophthalmol Shandong University, 2007, 21(1):60-61,64.
[2] 王强, 宋西成, 姜绍红, 等. 鼻内镜下鼻道黏骨膜翻瓣开窗治疗上颌窦良性病变[J]. 山东大学耳鼻喉眼学报, 2012, 26(4):34-35,38. WANG Qiang, SONG Xicheng, JIANG Shaohong, et al. Endoscopic nasal meatusmucoperiosteal flap fenestration in the treatment of maxillary sinus benign diseases[J]. J Otolaryngol Ophthalmol Shandong University, 2012, 26(4):34-35,38.
[3] 张也. 经鼻内镜下鼻道开窗治疗上颌窦囊肿28例[J]. 中国实用医药, 2013, 36 (1):111-112. ZHANG Ye. Nasal endoscopic nasal meatus fenestration in the treatment of maxillary sinus cyst in 28 cases[J]. Chin Practical Med, 2013, 36(1):111-112.
[4] Stevens M H. Primary fungal infections of the paranasal sinuses[J]. Am J Otolaryngol, 1981, 2(4):348-357.
[5] Tsai T L, Guo Y C, Ho C Y, et al. The role of ostiomeatal complex obstruction in maxillary fungus ball[J]. Otolaryngol Head Neck Surg, 2006, 134(3):494-498.
[6] Stammberger H, Jakse R, Beaufort F. Aspergillosis of the paranasal sinuses x-ray diagnosis, histopathology, and clinical aspects[J]. Ann Otol Rhinol Laryngol, 1984, 93(3 Pt 1):251-256.
[7] Lee K C. Clinical features of the paranasal sinus fungus ball[J]. J Otolaryngol, 2007, 36(5):270-273.
[8] Kirihene R K, Rees G, Wormald P J. The influence of the size of the maxillary sinus ostium on the nasal and sinus nitric oxide levels[J]. Am J Rhinol, 2002, 16(5):261-4.
[9] Hosemann W, Scotti O, Bentzien S. Evaluation of telescopes and forceps for endoscopic transnasal surgery on the maxillary sinus[J]. Am J Rhinol, 2003, 17(5):311-316.
[10] 许成利, 许庚. 鼻内镜下上颌窦开口的形态学观察[J]. 临床耳鼻咽喉头颈外科杂志, 2010,24(5):231-232. XU Chengli, XU Geng. The morphology of maxillary sinus opening under nasal endoscopy [J]. J Clin Otolaryngol Head Neck Surgery, 2010, 24(5):231-232.
[11] 黄少鹏, 李瑞玉, 叶青, 等. 鼻内镜手术治疗真菌球型鼻窦炎52例[J]. 福建医科大学学报, 2007,41(4):377-378. HUANG Shaopeng, LI Ruiyu, YE Qing, et al. Nasal endoscopic operation intreatment of fungus ball nasosinusitis in 52 cases [J]. J Fujian Med University, 2007, 41(4):377-378.
[1] 刘定荣,史余勇,詹先进,刘贵凌,廖新春,杨吉,罗泽辉,罗永华,廖宽,吴轲. 鼻腔结构与真菌性上颌炎关系的CT影像学研究[J]. 山东大学耳鼻喉眼学报, 2016, 30(5): 94-97.
[2] 樊贤超,吴元庆,邓毅. 鼻内镜下上颌窦良性病变不同手术入路的治疗体会[J]. 山东大学耳鼻喉眼学报, 2009, 23(6): 55-56.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!