上颌窦冲洗在鼻内镜治疗真菌球型上颌窦炎中的应用

Maxillary sinus irrigation in treating fungal ball maxillary sinusitis under endoscopic sinus surgery

目的探讨鼻内镜手术结合术中冲洗治疗真菌球型上颌窦炎的疗效。方法 2009年12月至2012年12月我科共诊治55例真菌球型上颌窦炎患者,随机分成两组。A组27例,采用单纯鼻内镜中鼻道径路治疗;B组28例,采用鼻内镜中鼻道径路结合术中冲洗治疗。术后随访,比较两组疗效。结果术后随访至少6个月,两组术中、术后均无并发症发生。A组治愈21例,有6例复发,在第2次手术时术中冲洗最终治愈;B组治愈28例,无1例复发。B组疗效明显优于A组。结论相比较单纯鼻内镜中鼻道径路手术,鼻内镜中鼻道径路手术结合术中冲洗治疗真菌球型上颌窦炎具有更确切的疗效,符合微创理念,值得临床推广。

Objective To investigate the clinical efficacy of endoscopic sinus surgery in combination with intra-opera- tive irrigation in treating patients with fungal ball maxillary sinusitis. Methods Fifty-five patients with fungal ball max- illary sinusitis were treated by endoscopy in our department from December 2009 to December 2012 . They were ran- domly divided into two groups. Twenty seven patients were treated with endoscopic middle nasal meatus approach （ group A） and 28 were treated with middle nasal meatus approach in combination with intra-operative sinus irrigation （ group B）. Results Followed up for at least 6 months, no complications happened in two groups. There were 21 pa- tients in group A were cured and 6 recurred, and there were 28 patients in group B were cured without recurrence. The therapeutic effect of group B was significantly better than that of group A. Conclusion Middle meatus approach sur- gery in combination with intra-operative sinus irrigation is more effective than pure endoscopic middle meatus approach in treatment of fungal ball maxillary sinusitis.