Wiatrak B J, Willging P, Myer C M, Cotton R T
University of Michigan Medical Center, Ann Arbor.
Otolaryngol Head Neck Surg. 1991 Dec;105(6):818-25. doi: 10.1177/019459989110500608.
Fungal sinusitis in the immunocompromised child is an aggressive, invasive process that may result in a fatal outcome if not diagnosed early. As a result of increasing use of bone marrow transplantation and new cytotoxic chemotherapeutic agents resulting in severe agranulocytopenia, more patients have become susceptible to fungal sinus disease. Functional endoscopic sinus surgery has emerged recently as an important surgical modality in the treatment of sinus disease in adults and children. Use of this technique in immunosuppressed children has allowed early diagnosis of fungal sinonasal disease, resulting in earlier surgical intervention. The high-quality fiberoptic capability of nasal endoscopes allows very detailed visualization of the internal anatomy of the nose and detects early mucosal changes as a result of intranasal fungal disease. Our experience using functional endoscopic sinus surgery in immunocompromised children over an 18-month period is reviewed. Our philosophy for diagnosis and management of immunocompromised children with suspected fungal sinonasal disease is discussed.
免疫功能低下儿童的真菌性鼻窦炎是一种侵袭性过程，如果不及早诊断，可能导致致命后果。由于骨髓移植和新型细胞毒性化疗药物的使用增加，导致严重粒细胞缺乏，越来越多的患者易患真菌性鼻窦疾病。功能性内镜鼻窦手术最近已成为治疗成人和儿童鼻窦疾病的一种重要手术方式。在免疫抑制儿童中使用这种技术能够早期诊断真菌性鼻窦疾病，从而实现更早的手术干预。鼻内镜的高质量光纤功能可非常详细地观察鼻腔内部解剖结构，并检测鼻内真菌病导致的早期黏膜变化。本文回顾了我们在18个月期间对免疫功能低下儿童使用功能性内镜鼻窦手术的经验。并讨论了我们对疑似真菌性鼻窦疾病的免疫功能低下儿童的诊断和管理理念。
