Mann W, Bumb P, Märker-Hermann E
HNO-Klinik und Poliklinik der Johannes-Gutenberg-Universität Mainz, Langenbeckstrasse 1, 55131 Mainz, Deutschland.
HNO. 2008 Nov;56(11):1129-34. doi: 10.1007/s00106-008-1699-9.
Chronic rhinosinusitis together with nasal septal perforation with or without pain of the nasal skeleton and without previous trauma or surgery point toward the possible diagnosis of Wegener's granulomatosis. However, nasal biopsy and serologic testing remain inconclusive in many patients. The otolaryngologist's role in this situation is to initiate, in close cooperation with a rheumatologist, therapy with sulfatrimethoprim, as well as with immunosuppressants if necessary. This helps stabilize the symptomatology and may prevent progressive systemic disease.
慢性鼻窦炎合并鼻中隔穿孔，伴有或不伴有鼻骨疼痛，且无既往外伤或手术史，提示可能诊断为韦格纳肉芽肿。然而，在许多患者中，鼻活检和血清学检测结果仍不明确。在这种情况下，耳鼻喉科医生的作用是与风湿病学家密切合作，开始使用复方磺胺甲恶唑进行治疗，必要时联合使用免疫抑制剂。这有助于稳定症状，并可能预防全身性疾病进展。
