双侧与单侧真菌球型鼻窦炎的临床及影像学特征比较

Comparison of clinical and imaging characteristics of bilateral and unilateral fungal balls

目的 回顾性分析1753例真菌球型鼻窦炎患者的临床及影像学特征。方法 收集首都医科大学附属北京同仁医院耳鼻咽喉头颈外科1753例真菌球型鼻窦炎患者的临床及影像学资料。将患者分为双侧和单侧真菌球两组,总结并分析各组的临床表现及术前影像学特征。结果 双侧和单侧真菌球患者分别为63例和1690例。15.9%的双侧和8.6%的单侧真菌球患者出现糖尿病(P=0.020)。在双侧真菌球患者中,脓涕、疼痛、涕倒流显著高于单侧受累的发生率(P<0.05)。骨质吸收征象在双侧真菌球组更为常见,可见于31.7%的双侧和15.6%的单侧真菌球患者(P=0.001)。结论 双侧真菌球型鼻窦炎与糖尿病关系更密切。双侧真菌球型鼻窦炎患者更多以脓涕、涕倒流、疼痛症状就诊。双侧真菌球型鼻窦炎受累鼻窦出现骨质压迫吸收的比例更高。

OBJECTIVE To study the clinical and imaging characteristics of bilateral and unilateral fungal balls.METHODS We retrospectively analyzed clinical and imaging features of 1753 cases of fungal ball.All the cases were reviewed from the case database of Beijing Tongren Hospital.The patients were divided into two groups:bilateral and unilateral fungal ball.The clinical characteristics and preoperative imaging features of each group were analyzed.RESULTS Among the patients,63 had bilateral fungal ball and 1690 had unilateral fungal ball.Diabetes mellitus was noted in 15.9%of the bilateral fungal ball and 8.6%of the unilateral fungal ball individuals(P=0.020).In patients with bilateral fungal ball,the incidence of purulent rhinorrhea,pain and post nasal drip were significantly higher than those in patients with unilateral fungal ball,respectively(all P<0.05).Bone resorption was more common in the bilateral fungal ball group,seen in 31.7%of bilateral and 15.6%of unilateral patients,respectively(P<0.01).CONCLUSION Bilateral fungal ball is more closely related to diabetes mellitus.Patients with bilateral fungal balls were more likely to present with purulent rhinorrhea,pain and post nasal drip.The proportion of bone compression and absorption in bilateral fungal ball involved paranasal sinuses was higher.