真菌性鼻窦炎的内窥镜治疗

Endoscopic sinus surgery for mycotic nasosinusitis

目的 探讨经鼻内窥镜治疗真菌性鼻窦炎的手术方法、疗效及适应症。方法 对我科近年经鼻内窥镜治疗或同时施行Caldwell-Luc手术的21例真菌性鼻窦炎进行总结分析。结果21例原症状手术后均消失,术后2～3个月鼻内窥镜检查,窦腔内上皮化,窦口引流通畅,随访6个月～5年,21例均治愈,无一例复发。结论 经鼻内窥镜处理窦口鼻道复合体病变,保持窦口引流通畅是预防复发的重要因素之一,在处理筛窦、蝶窦病变时,内窥镜具有无可比拟的优势,严重上颌窦真菌病仍不能替代Caldwell-Luc手术,术后鼻内窥镜下清理术腔,可巩固疗效,促使早日痊愈。

Objective To evaluate the therapeutic effect of endoscopic sinus surgery (ESS) on mycotic nasosinusitis. Methods A clinical analysis was made on 21 cases with mycotic nasosinusitis treated by ESS and/or Caldwell-Luc surgery in our hospital during recently years. Results Symptoms were disappeared in all patients after surgery, with epithelization in the sinus cavity and adequate drainage of the ostium 2 - 3 months post-operation, when examined under endoscope, and all were cured during a following-up period of 6 months to 5 years. Conclusion the most important things for the treatment of this condition are to treat the lesions with os-tiomeatal complex under endoscope properly and to keep the ostium drinaging adequately. While ESS can be used exclusively to treat lesions in ethmoidal and sphenoid sinuses with advantages, Caldwell-Luc surgery is un-substitutable totally for the treatments of serious mycotic maxillary sinusitis. However, its healing will be promoted with the help of endoscope to treat the surgical cavity after surgery.