Nomura Kazuhiro, Ikushima Hiroyuki, Ozawa Daiki, Shimizu Yuichi, Arakawa Kazuya, Suzuki Jun, Hidaka Hiroshi, Katori Yukio, Ohyama Kenji
Department of Otolaryngology, Tohoku Rosai Hospital.
Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.
J Craniofac Surg. 2018 May;29(3):e304-e307. doi: 10.1097/SCS.0000000000004379.
Sinus fungal ball is defined as noninvasive chronic rhino-sinusitis with a clump of mold in the paranasal sinuses, typically affecting the maxillary sinus. Fairly good outcomes of endoscopic surgery have been reported where the ball is removed through the antrostomy. However, the affected sinus tends to have a smaller cavity and thicker bony walls. As such, it is often challenging to maintain a window size that is sufficient to control possible recurrence. The endoscopic modified medial maxillectomy procedure was applied to a 61-year old and a 70-year old female patient with maxillary sinus fungal ball. Using this method, we created a much larger inferior meatal antrostomy without difficulty. The window provided us with an endoscopic view of the whole sinus and complete eradication of the lesion. Endoscopic modified medial maxillectomy is useful as a surgical procedure for maxillary sinus fungal ball and should be considered for better outcomes.
鼻窦真菌球被定义为鼻窦内有一团霉菌的非侵袭性慢性鼻-鼻窦炎，通常累及上颌窦。据报道，通过上颌窦造口术取出真菌球的内镜手术效果相当不错。然而，受累鼻窦往往腔隙较小且骨壁较厚。因此，维持足以控制可能复发的窗口大小往往具有挑战性。内镜改良内侧上颌骨切除术应用于一名61岁和一名70岁患有上颌窦真菌球的女性患者。使用这种方法，我们轻松地创建了一个大得多的下鼻道上颌窦造口术。该窗口为我们提供了整个鼻窦的内镜视野，并实现了病变的彻底清除。内镜改良内侧上颌骨切除术作为上颌窦真菌球的一种手术方法是有用的，为了获得更好的效果应予以考虑。
