关键词: 真菌鼻, 窦炎, 诊断, 内窥镜检查, 治疗

Abstract: Objective To explore the treatment method for mycotic maxillary sinusitis. Methods 32 patients hospitalized from June 2003 to June 2006 were treated by an inferior nasal concha flipping pathway. All patients are characterized with a fully occupied maxillary antrum cavity, and the pathological tissues could not be completely removed through middle or sub. 19 patients featured bone destruction or absorption to different degrees. All patients underwent rhinoendoscope surgeries. The inferior nasal concha was partly cut off 0.5 cm from the anterior adhering point, and the hamular process and the tissues around the opening of maxillary sinus as well as the tissues of the inferior nasal meatus were removed. The inferior nasal concha was made into a banded tissue flap with the pedicle at the rear, and then based on the situation, it was flipped backwards or upwards exposing the fields of view in the operations. Using 0°, 30° and 70° endoscopes, the disordered tissues in the endo-inferior part of maxillary cavity were erased using a curette, and the lacrimal canal in the front end and the sphenopalatine artery were well preserved. After complete removal of the disordered tissues, the inferior nasal concha was repositioned, and the anterior incisions were sutured or glued. Results All disordered tissues were completely removed and no recurrence was found after a followup of 1 to 4 years. 5 patients complained about dry nasal cavities and after a nasal douche their symptoms disappeared in 15 to 30 days. 3 months after the operations no complaints about dry nasal cavities or headache were found. No nasal synechia, angusty or necrosis were found. Conclusions Inferior nasal concha flipping can reduce trauma, avoid labiogingval incisions and provides an expansive field of view. Especially when it comes to the management of the endoinferior part of the maxillary antrum, the pathway can be discharged through the middle meatus. The pathway also provides an expansive field of view for postoperative recheck and management for relapse. By preserving the structure and volume of the inferior nasal concha, the sequel of dry nasal cavity, incrustation and headache are decreased. 

Key words: Fungi, Sinusitis, Diagnosis, Endoscopy, Therapy