上颌窦真菌球位置对手术径路选择的影响  

Effect Of The Various Distribution Of Fungal Ball In Maxillary Sinus On The Operative Pathway Choice

作　　者：李嘉[1] 李铎贤[1] 叶远航[1] 张正刚[1] 

机构地区：[1]广东省梅州市人民医院耳鼻咽喉科,梅州514031

出　　处：《航空航天医学杂志》2011年第5期539-541,共3页Journal of Aerospace medicine

摘　　要：目的:探讨上颌窦真菌球不同病变分布位置对手术治疗径路选择的影响。方法:回顾性分析95例96侧患者在鼻内镜下分别经单纯上颌窦自然开口径路法(A组,45例45侧)、柯-陆术式加上颌窦自然开口双径路法(B组,28例28侧)、上颌窦前壁钻孔加上颌窦自然开口双径路法(C组,22例23侧)治疗的临床资料,并将其中真菌球分布位置与疗效间关系进行分析。结果:A组41例治愈,其中真菌球位置非位于窦口区者中有4例复发;B组及C组全部治愈。复发病例均经C组方法治愈。结论:鼻内镜技术是治疗上颌窦真菌感染的有效方法。对真菌球位于窦口且引起阻塞者可采用单纯经上颌窦自然开口径路法;而病灶非位于窦口者,首选上颌窦前壁钻孔加上颌窦自然开口双径路法。Objective：To investigate the effect of the various distribution of fungal ball in maxillary sinus on the operative pathway choice.Methods：The data of 95 in 96 cases of patients who underwent fungal maxillary sinusitis was retrospectively reviewed.45 of them（Group A） were accepted the path of simple endoscopic maxillary sinus surgery,28（Group B） the path of endoscopic maxillary sinus surgery plus Caldwell-Luc surgery,and 22 in 23 cases（Group C） the path of endoscopic maxillary sinus surgery plus drilling anterior wall of maxillary sinus surgery.The relation between the distribution of fugus ball and the effection was analyzed.Results：All patients were cured in Group B and C,4 recurrent patients in Group A,whose fungal ball didn′t located in maxillary sinus ostium,were cured by the path of endoscopic maxillary sinus surgery plus drilling anterior wall of maxillary sinus surgery.Conclusions：Endoscopic technique is aneffective way in the treatment of fungal maxillary sinusitis.The patients,whose fungal ball locate in and block maxillary sinus ostium,can adopt the path of simple endoscopic maxillary sinus surgery,otherwise,the path of endoscopic maxillary sinus surgery plus drilling anterior wall of maxillary sinus surgery should be regarded as the first choice.

关 键 词：真菌病 上颌窦炎 鼻内镜手术 

分 类 号：R765.4[医药卫生—耳鼻咽喉科]