摘要
目的比较鼻内镜下上颌窦开放术和上颌窦根治术治疗非侵袭性真菌性上颌窦炎的疗效。方法本科收治的真菌性上颌窦炎患者89例(102侧),将其分为两组,A组39例(49侧,经鼻内镜开放上颌窦自然口并保留鼻窦黏膜);B组50例(53侧,上颌窦根治术+下鼻道造口术)。术后6个月开始随访,24个月时终止。结果(1)术后疗效:A组显效36例(92.3%),B组35例(68.6%),两组显效率比较差异有统计学意义(P<0.05)。(2)鼻窦局部形态:A组窦口引流通畅,窦内黏膜恢复好39侧(79.6%),迁延性炎性反应9侧(18.4%),窦口闭塞1侧(2.0%);B组下鼻道造口引流通畅、窦内光滑13侧(24.5%),下鼻道造口狭窄、窦内纤维结缔组织增生或瘢痕样组织增厚26侧(49.1%),窦口闭塞14侧(26.4%),两组间差异具有统计学意义(P<0.05)。结论鼻内镜上颌窦开放术并保留窦腔黏膜治疗真菌性上颌窦炎效果优于传统上颌窦根治术。
Objective To compare the curative effect of antrostomy and radical maxillary sinusotomy with retaining the nasal sinuses mueosa on non-invasive fungal rbinosinusitis. Methods Eighty-nine patients （ 102 sides） with non-invasive fnngal rhinosinusitis were divided into two groups. Cases in group A（ 39 cases, 49 sides） accepted antrostomy under the endoscopy with retaining the nasal sinus mueosa. Group B （50 cases ,53 sides）accepted radical maxillary sinusotomy with neostomy of inferior meatus respectively, with retaining the sinus mucosa under endoscopy. Follow-up was performed from 6 months to 24 months after the operation. Results Symptoms were improved in 36 cases （92.3%） in group A and 35 cases（68.6% ） in group B, with significant difference between them （P 〈0.05）. In group A, adequate drainage of ostiums opertures and ideal recovery of the accessory nasal sinuses mucosa was observed in 39 sides （79.6%） ,unresolved inflammation in 9 sides （ 18.4% ） and obstruction of the ostiums opertures in 1 side （2.0%）. While in group B, adequate drainage of inferior meatus ostium and lubricity in sinuses was found in 13 sides （22.6%） , structure of infcror meatus ostium and hyperplasia of fibrillar connective tissue or nerassation of cieatrical tissue inside sinus in 26 sides （49.1%） , and obstruction of ostiums opertures in 14 sides （26.4%）. The difference of the conditions of ostiums opertures between group A and B was significant （ P 〈 0.05 ）. Conclusions Antrostomy under the endoscopy with retaining the nasal sinus mucosa was better than traditional radical maxillary sinusotomy in the treatment of non-invasive fungal rhinosinusitis. （ Chin J Ophthalmol and Otorhinolaryngol,2008,8：357-359）
出处
《中国眼耳鼻喉科杂志》
2008年第6期357-359,I0006,共4页
Chinese Journal of Ophthalmology and Otorhinolaryngology
基金
浙江省金华市科技局科研基金资助(2006-3-049)
关键词
上颌窦炎
真菌性
上颌窦根治术
治疗
Maxillary sinusitis, fungal
Radical maxillary sinusotomy
Treatment
