Kim Jong Sei, Kim Byung Kil, Hong Sang Duk, Kim Hyung Jin, Kim Hyo Yeol
Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Clin Exp Otorhinolaryngol. 2016 Dec;9(4):326-331. doi: 10.21053/ceo.2015.01571. Epub 2016 May 3.
A sphenoid sinus fungal ball is a rare disease that can cause visual disturbances. Most afflicted patients remain in an indolent state. However, once the visual disturbance has occurred, the recovery rate is very low. The purpose of this study was to overview the clinical characteristics of patients with a sphenoid sinus fungal ball and ascertain factors possibly related to the occurrence of a visual disturbance.
We retrospectively reviewed the medical records of all patients who underwent endoscopic sinus surgery for a sphenoid sinus fungal ball at our hospital. We enrolled 47 patients in this study.
Old age and a female predominance were noted. Nasal symptoms were the most common symptom. Eight patients showed visual disturbances. We also compared the clinical characteristics between patients with and without visual disturbances in univariate analysis. Old age, underlying diabetes mellitus, and a sphenoid sinus wall defect visible by computed tomography were factors significantly related to the occurrence of visual disturbances. But only sphenoid sinus wall defect showed significance in multivariate analysis.
It is important to prevent complications, such as visual disturbance, in patients with a sphenoid sinus fungal ball. This study describes an early surgical treatment that may be required for patients with a sphenoid sinus fungal ball and particularly patients with a sphenoid sinus wall defect.
蝶窦真菌球是一种可导致视觉障碍的罕见疾病。大多数患病患者处于病情进展缓慢的状态。然而,一旦出现视觉障碍,恢复率非常低。本研究的目的是概述蝶窦真菌球患者的临床特征,并确定可能与视觉障碍发生相关的因素。
我们回顾性分析了我院所有因蝶窦真菌球接受鼻内镜鼻窦手术患者的病历。本研究纳入了47例患者。
发现患者以老年居多且女性占比高。鼻部症状是最常见的症状。8例患者出现视觉障碍。我们还在单因素分析中比较了有视觉障碍和无视觉障碍患者的临床特征。老年、潜在的糖尿病以及计算机断层扫描可见的蝶窦壁缺损是与视觉障碍发生显著相关的因素。但在多因素分析中只有蝶窦壁缺损具有统计学意义。
预防蝶窦真菌球患者出现视觉障碍等并发症很重要。本研究描述了蝶窦真菌球患者,特别是有蝶窦壁缺损的患者可能需要的早期手术治疗。