真菌球型真菌性鼻窦炎及其骨炎临床特征

Clinical characteristics of fungal ball sinusitis and it’s osteitis

目的研究真菌球型真菌性鼻窦炎(FBS)及其骨炎临床特征。方法回顾性分析105例(共110窦)FBS患者的临床资料,总结分析其症状、体征、影像学特点、病理特点以及骨炎的临床特征。结果110窦中97窦(88.2%)位于上颌窦,13窦(11.8%)位于蝶窦;97窦(88.2%)较对侧(即健侧)鼻窦存在骨质不同程度增厚。病变鼻窦及对侧鼻窦窦壁骨质在厚度(0.34±0.17 vs.0.14±0.08)、CT值(1161.5±322.5 vs.864.2±482.8)、骨炎GOSS评分(3.0±1.4 vs.0.3±0.9)三个方面均存在明显统计学差异。病理学观察病变鼻窦骨质存在明显骨髓炎的表现并伴有骨质重塑活动。结论真菌球型真菌性鼻窦炎好发于上颌窦和蝶窦,单窦为主。大部分病变鼻窦窦壁骨质存在明显的骨炎,主要表现为骨质增厚以及CT值增高。

Objective The aim of this study is to the clinical features of fungal spheroid fungal sinusitis and osteitis.Methods The clinical data of 105 FBS patients(110 sinuses in total)were retrospectively analyzed,the clinical features of theiRsymptoms,signs,image,pathology,and osteitis were summarized and analyzed.Results Among the 110 sinuses,97 sinuses(88.2%)were located in the maxillary sinus,and 13 sinuses(11.8%)were located in the sphenoid sinus;97 sinuses(88.2%)had different degrees of bone thickening compared with the contralateral sinus.The wall bone of lesion sinus and contralateral sinus were significantly different in bone thickness(0.34±0.17 vs.0.14±0.08),CT value(1161.5±322.5 vs.864.2±482.8),GOSS score(3.0±1.4 vs.0.3±0.9).Pathological observation showed manifestations of osteomyelitis accompanied by bone remodeling activities.Conclusion Fungal spheroid fungal sinusitis prefeRto occurs in the maxillary sinus and sphenoid sinus,mainly in single sinus.Most of the wall bone around the lesion sinuses have obvious osteitis,which is mainly characterized by bone thickening and increased CT value.