孤立性真菌性蝶窦炎的诊断与治疗现状

Diagnosis and treatment of isolated fungal sphenoid sinusitis

真菌性鼻-鼻窦炎是常见的特异性感染性疾病,虽然较少孤立发生于蝶窦,但由于其症状和体征缺乏特异性,加之蝶窦解剖位置隐蔽,缺乏简单易行的检查方法,临床上经常漏诊和误诊,易侵犯眶尖和颅内,危害较大.真菌性疾病在临床上逐年增多,且根据患者主诉往往就诊于神经内科、眼科等,首诊通常不在耳鼻咽喉科,因而明确诊断和及时治疗存在一定的难度.随着细菌学、血清学、病理学免疫组化及影像学的发展,真菌的检出率明显提高.本文就近年来该疾病的诊断、治疗进展做一综述.

Fungal rhinosinusitis is a common specific infectious disease.Although it rarely occurs in the sphenoid sinus in isolation,it is often missed and misdiagnosed in clinic due to the lack of specificity in symptoms and signs,the concealed anatomical position of the sphenoid sinus,and the lack of simple and easy inspection methods.It is easy to invade the orbital apex and intracranial,which is harmful.Fungal diseases are increasing year by year in clinical practice.According to the patient's main complaint,they are often seen in n euro logy,ophthalmology,etc.the first diagnosis is usually not in otorhinolaryngology,so it is difficult to make clear the diagnosis and timely treatment.With the development of bacteriology,serology,pathology,immunohistochemistry and imaging,the detection rate of fungi has increased significantly.In this paper,the diagnosis and treatment of the disease in recent years are discussed andreviewed.