上颌窦霉菌病的鼻内镜手术治疗  

Treatment of mycosis of maxillary sinus by nasal endoscopic surgery

作　　者：胡建文[1] 曾一民[1] 杨国存[1] 

机构地区：[1]温州市第二人民医院耳鼻咽喉科,温州325000

出　　处：《中国微创外科杂志》2004年第1期74-75,共2页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的　探讨鼻内镜下单纯上颌窦口扩大术治疗非侵袭性霉菌球型上颌窦炎的疗效。　方法　回顾分析 16例非侵袭性霉菌球型上颌窦炎的临床资料。　结果　手术时间 30～ 12 0min ,平均 6 0min。无手术并发症发生。住院 5～ 7d ,平均 6d。 16例术后病理找到菌丝和孢子 ,9例霉菌培养为曲霉菌。 16例术后随访 3～ 2 4个月 ,平均 18个月 ,14例无症状 ,内镜示窦口通畅 ,窦腔粘膜正常 ;2例复发 ,再次扩大窦口 ,分别随访 6、13个月无复发。　结论　非侵袭性霉菌球型上颌窦炎鼻内镜下单纯上颌窦口扩大术可达到根治和微创的临床效果 ,但应特别注意窦口处理。Objective To explore the curative effect of endoscopic simple maxillary ostium enlargement in the treatment of non-invasive mycosis of maxillary sinus. Methods Clinical data of 16 cases of noninvasive mycosis of maxillary sinus were analyzed retrospectively. Results The operation time was 30～120 minutes, with a mean of 60 minutes. No operative complications occurred. The hospital stay was 5～7 days, with a mean of 6 days. Histopathological examination found hyphae and spores in 16 cases, and a positive culture of Aspergillus was observed in 9 cases. Postoperative follow-up for 3～24 months (mean, 18 months) in 16 cases revealed free of symptoms in 14 cases, in which the endoscopic examination showed unobstructed ostium and normal sinusal mucosa, and recurrence in 2 cases, who underwent repeated enlargement of ostium and were re-followed for 6 and 13 months, respectively, without recurrence. Conclusions Nasal endoscopic simple maxillary ostium enlargement in the treatment of non-invasive mycosis of maxillary sinus is a radical and minimally invasive technique, but particular attention must be directed to managing the maxillary ostium.

关 键 词：鼻内镜 霉菌病 上颌窦炎 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]