Abstract：Objective: To investigate the clinical effects of different surgical methods on non-invasive fungal maxillary sinusitis, and then to guide the surgical operation. Methods: Sixty - six patients with non - invasive fungal maxillary sinusitis underwent endoscopic sinus surgery (ESS) were divided into three groups: 25 cases were treated with endoscopic maxillary sinus windowing (EMSS) ,simple endoscopic maxillary sinus open - (EMIF group), 22 cases of nasal endoscopy combined with inferior meatus pathways group (EMIF group) , opening combined with glottic sulcus approach group (ESSL group) in 19 cases under nasal endoscopic nasal .The clinical symptoms, the situation of nasal cavity and paranasal sinus lesions were compared between the three groups. Results: The therapeutic effect was evaluated by the standard of Haikou. The effective rates of EMSS, EMIF and ESSL were 80.0%, 94.7% and 100%, respectively. Compared with EMIF group and ESSL group, EMSS had significant difference (P<0.05). There was no significant difference between EMIF group and ESSL group (P>0.05). There were no significant differences in the VAS score, Lund-Kennedy endoscopic score and Lund-Mackay CT score between the three groups before operation (P>0.05). There were significant differences between EMSS group and EMIF group and ESSL group before and after operation (P <0.05). There were significant differences between EMSS group and EMIF group and ESSL group after operation (P<0.05) .There was no significant difference between EMIF group and ESSL group (P> 0.05). The VAS score, Lund-Kennedy endoscopic score and Lund-Mackay CT score were highest in the EMSS group at 6 months postoperatively. Conclusions: The combined approach has better therapeutic effect on non-invasive fungal maxillary sinusitis than EMIF and ESSL. However, the effect of EMIF and ESSL is not different. However, Trauma of the inferior meatus window is less, less blood and more convenient operation.It is an ideal method In clinical treatment of Non-invasive fungal maxillary sinusitis and worthy of promotion.
[1] Hashemi SJ, Ardehali MM, Rezaie S, et al. A case of fungus ball-type pansinusitis due to fusarium proliferatum [J].Mycopathologia, 2015,180(3-4):251~255. [2] 慢性鼻-鼻窦炎诊断和治疗指南(2012,昆明)[J].中国医刊,2013,48(11):103~105 [3] 施清圆,董守豪,吴丽萍,等. 鼻内镜下中下鼻道上颌窦联合开窗术治疗真菌球性上颌窦炎的随机对照试验 [J].中国循证医学杂志, 2013,13(7):801~806 [4] 陈莹华, 张红春, 葛平江, 等. 鼻内镜下中鼻道联合下鼻道扩大泪前隐窝入路切除上颌窦良性病变 [J].临床耳鼻咽喉头颈外科杂志, 2012,(23):1070~1076. [5] Sawatsubashi M, Murakami D, Umezaki T, et al. Endonasal endoscopic surgery with combined middle and inferior meatal antrostomies for fungal maxillary sinusitis [J]. J Laryngol Otol, 2015,129 Suppl 2(52~55). [6] Raz E, Win W, Hagiwara M, et al. Fungal sinusitis [J].Neuroimaging Clin N Am, 2015,25(4):569~576.
2017, Vol. 23 
冀公网安备13080202000677号