Ear Nose and Throat Unit, Department of Surgery, Korle-Bu Teaching Hospital.
Division of Neurosurgery, Department of Surgery, Korle-Bu Teaching Hospital.
Curr Opin Otolaryngol Head Neck Surg. 2020 Jun;28(3):182-187. doi: 10.1097/MOO.0000000000000629.
Complicated rhinosinusitis continues to be a diagnosis not to be missed because of the potential life-threatening and life-changing outcomes. This is true for clinicians in both developed and developing countries. Advances in diagnostic imaging, appropriate antibiotic use and timely surgical intervention have resulted in better outcomes particularly in the developed world. This review focuses on the current management of complicated sinusitis in resource-limited settings.
Recent publications indicate leaning toward endoscopic sinus surgery as a standalone procedure or in combination with traditional external approaches in the management of complicated rhinosinusitis with less morbidity and shorter recovery time. It is becoming increasingly evident that multidisciplinary specialties should be involved in the effective management of patients with complicated sinusitis.
Early recognition, prompt surgical intervention and antibiotic therapy remain keys in the management of complicated rhinosinusitis. In many African countries and other developing countries, the absence of specialized imaging and endoscopic diagnostic equipment and endoscopic surgical facilities and expertise means that reliance must be placed on clinical acumen both for diagnosis and monitoring of treatment response of complicated sinus infections.
由于潜在的危及生命和改变生活的后果,复杂的鼻窦炎仍然是一个不容忽视的诊断。这对于发达国家和发展中国家的临床医生来说都是如此。诊断成像技术、适当的抗生素使用和及时的手术干预方面的进步,特别是在发达国家,带来了更好的结果。本篇综述聚焦于资源有限环境下复杂鼻窦炎的当前治疗方法。
最近的出版物表明,倾向于将内镜鼻窦手术作为一种独立的手术方法,或与传统的外部方法联合使用,用于治疗复杂的鼻窦炎,具有更低的发病率和更短的恢复时间。越来越明显的是,多学科专业应该参与到复杂鼻窦炎患者的有效管理中。
早期识别、及时的手术干预和抗生素治疗仍然是治疗复杂鼻窦炎的关键。在许多非洲国家和其他发展中国家,缺乏专门的影像学和内镜诊断设备以及内镜手术设施和专业知识,这意味着必须依靠临床敏锐度来进行诊断,并监测复杂鼻窦感染的治疗反应。