【摘要】 目的:探讨孤立性真菌球型蝶窦炎的临床特征及鼻内镜手术疗效。方法:回顾性分析13例确诊为孤立性真菌球型蝶窦炎患者的临床症状、鼻内镜检查所见、影像学特点、鼻内镜手术疗效。结果:临床症状为头痛10例次(77%),涕中带血2例次(15%)。鼻内镜检查发现蝶窦自然口周黏膜息肉样变6例,蝶窦自然口闭锁1例。鼻窦CT扫描显示全部病例单侧蝶窦腔内混浊影,其中有高密度的钙化斑块或斑点9例,窦腔骨壁增厚6例,蝶窦前壁破坏2例,窦腔内有气泡样影2例。全部患者采用经蝶窦自然口径路鼻内镜下蝶窦开放术,术后随访1～4年,临床症状消失,术腔清洁,无一例复发。结论:孤立性真菌球型蝶窦炎临床症状无特异性,以头痛最为常见;鼻窦CT扫描显示蝶窦腔内混浊影伴有斑点状或条块状钙化是本病最具特征性的表现;鼻内镜结合鼻窦CT检查可提高本病的诊断率;鼻内镜下经蝶窦自然口径路蝶窦开放术是治疗本病的首选方法。更多还原

【Abstract】 Objective:To investigate the clinical characteristics and the outcomes of endoscopic surgery in 13 patients with isolated fungus ball sphenoid sinusitis.Methods:A retrospective study was made on 13 cases of isolated fungus ball sphenoid sinusitis to discuss the clinical manifestation,endoscopic findings,computed tomography features and the result of endoscopic surgery.Results:Presenting symptoms included headache(10 cases,77%)and bloody discharge(2 case,15%).Endoscopy showed that 6 patients had polyps in sphenoid sinus ostium,and 1 case with atresia of sphenoid sinus ostium.Nasal sinus CT scan showed complete opacification in all 13 cases,with 9 cases(69%)had plaque or cord shaped calcification,6 cases(46%)had bones wall thickening,2 cases(15%)had bone erosion of anterior sphenoid sinus,2 cases(15%)had shadow like "air bubble".All patients were treated by endonasal sphenoidostomy,no surgical complications were found.Follow-up ranged from 1 to 4 years,all symptoms disappeared.The surgical cavity was clean.No case recurred.Conclusions:The presenting symptoms of isolated fungus ball sphenoid sinusitis lould be nonspecific,the most common symptom is headache.A characteristic of computed tomography is plaque or cord shaped calcification in the showed opacification shadow,it has great value for the diagnosis of isolated fungus ball sphenoid sinusitis.Nasal endoscopy and computed tomography contribute to an increase in diagnosis of this disease.Endonasal sphenoidostomy is the first choice to treat isolated fungus ball sphenoid sinusitis.更多还原