孤立性真菌性蝶窦炎的鼻内镜手术治疗.docVIP

孤立性真菌性蝶窦炎的鼻内镜手术治疗 】目的提高对孤立性真菌性蝶窦炎的 认识，探讨其鼻内镜手术治疗的手术适应证、手术特 点及疗效等相关因素。方法回顾分析14例孤立性真 性蝶窦炎患者的临床表现、影像学特点、治疗结果 和随访情况。全部患者在鼻内镜下行蝶窦开放术。结 果术后4?6周窦腔及窦口处黏膜上皮化。所有患者 鼻内镜随访6?12个月，无术后并发症发生。结论孤 立性真菌性蝶窦炎以头痛等神经症状及眼部症状为主 要表现，其症状缺乏特异性，CT有助于早期诊断和 手术治疗。MRI检查有利于降低手术风险，鼻内镜下 矫正解剖异常同时蝶窦开放，术后鼻腔冲洗，保持 鼻腔通气和引流，效果显著。 关键词】孤立性真菌性蝶窦炎；鼻内镜手术; 蝶窦开放术 DOI： 10.14163/j.cnki.11-5547八.2015.23.018 Nasal endoscopic surgery in the treatment of isolated fungal sphenoiditis SUN Zhan-wei，ZHU Yan-xia. Department of Otorhinolaryngology, Luohe City Central Hospital，Luohe 462300，China Abstract】 Objective To improve understanding of isolated fungal sphenoiditis， and to investigate related factors， such as operative indications, operation characteristics, and curative effect, of nasal endoscopic surgery. Methods A retrospective analysis was made on clinical manifestations，imaging features, treatment results, and follow-up condition of 14 patients with isolated fungal sphenoiditis. All cases received nasal endoscopic sphenoidostomy. Results Epithelization of sinus cavity and sinus mucous occurred in 4?6 weeks after operation. Follow-up for 6?12 months was given to all patients by nasal endoscopic examination, and it showed no occurrence of complications. Conclusion Main manifestations of isolated fungal sphenoiditis included neurological sign as headache and eye sign， which is lack of specificity. CT is helpful for early diagnosis and surgical treatment. MRI detection can reduce surgical risk. Endoscopic correction and sphenoidostomy provides remarkable effect，along with postoperative nasal irrigation and maintenance of nasal ventilation and drainage. Key words】 Isolated fungal sphenoiditis； Nasal endoscopic surgery； Sphenoidostomy 孤立性真菌性蝶窦炎症状无特异性，常规检查不 易发现。往往因眼部症状或神经症状而就诊于神经科 或眼科，造成漏诊或误诊。为了加深对该病的认识， 本文回顾本院2007?2011年行鼻内镜诊断与治疗的 14例孤立性真菌性蝶窦炎患者资料，现将结果报告 如下。 1资料与方法 1.1 一般资料本组14例孤立性真菌性蝶窦炎患 者，其中男5例，女9例。年龄28?56岁，平均 年龄44岁。病程3个月?2年，首诊于神经内科9 例，首诊于眼科2例，首诊于耳鼻咽喉科3例。单 侧10例，双侧4例。所有患者都有不同程度的头痛 症状，并且是其中9例的唯一症状，部位以眼球深 部，双颞部疼痛多见，其次为额