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目的:探讨孤立性真菌性蝶窦炎的影像学特征和鼻内镜手术效果。方法:16例患者术前行CT检查,均提示窦腔内有片状破棉絮样或充满型或肿块状软组织阴影,软组织阴影中有斑点状高密度影;以鼻内镜手术扩大蝶窦口,彻底清理蝶窦腔内病灶。结果:16例手术经过均顺利,术中平均每例出血15～30ml,11例术后症状立即缓解;未出现明显的手术并发症。随访3～9个月,治愈15例,蝶窦前壁开放通畅,窦腔各壁光滑,无异常分泌物。好转1例,窦腔内有少量分泌物潴留,窦口黏膜水肿,经蝶窦腔冲洗及辅舒良喷鼻后好转。结论:CT对真菌性蝶窦炎的确诊有独特的价值,鼻内镜手术治疗本病,可直接开放蝶窦腔,直达病变区处理病灶,具有手术距离短、创伤小、出血少等优点。
Objective: To investigate the imaging features of isolated fungal sphenoid sinusitis and the effect of endoscopic sinus surgery. Methods: Twenty-six patients underwent preoperative CT examination. All of them showed that there were flaky lobed or filled soft or shadow soft tissue in the sinus cavity and speckled high density shadow in soft tissue shadow. , Completely clear the sphenoid cavity lesions. Results: All the 16 surgeries were successful. The mean intraoperative blood loss was 15-30ml. The postoperative symptoms of 11 patients were relieved immediately. There was no obvious complication of operation. All patients were followed up for 3 to 9 months. Fifteen cases were cured. The anterior wall of sphenoid sinus was open and smooth, and the walls of the sinus were smooth with no abnormal secretions. Improved in 1 case, a small amount of secretions in the sinus cavity retention, ostial mucosal edema, transsphenoidal sinus rinse and Fu Shu Liang nasal spray improved. Conclusion: The diagnosis of fungal sphenoid sinusitis has a unique value. Nasal endoscopic surgery for the treatment of the disease can be directly open the sphenoid sinus cavity, lesions directly to the lesion, with short operative distance, less trauma, less bleeding and so on.