Braun J J, Paurobally A E, Conraux C
Ann Otolaryngol Chir Cervicofac. 1987;104(1):1-8.
Principal characteristics of clinical and paraclinical pictures of nasosinusal aspergillosis (NSA) in 35 patients are analyzed and allow distinction of three main types of this nasosinusal fungal lesion. Localized, non-invasive nasosinusal aspergillosis (NINSA) is frequently of dental origin and presents as a chronic maxillary sinusitis resistant to conventional treatment. Serology is negative or non-significant for Aspergillus and recovery is complete after surgery. Invasive nasosinusal aspergillosis (INSA) affects debilitated patients (diabetes, immunodepression, malignant blood disease...), and presents with bone destruction, extension to orbit, base of skull and intracranial region, following an acute or subacute course with positive serology for Aspergillus. Early, wide surgical eradication is combined with local and general antifungal therapy but prognosis is poor. Allergic nasosinusal aspergillosis (ANSA), of more recent description, combines chronic sinusitis with severe nasosinusal polyposis, and specific histologic and immunologic features. Its course is favorable with corticoid therapy but long-term results are unknown.
分析了35例鼻-鼻窦曲霉菌病（NSA）患者的临床和辅助检查结果的主要特征，从而区分出这种鼻-鼻窦真菌性病变的三种主要类型。局限性、非侵袭性鼻-鼻窦曲霉菌病（NINSA）通常源于牙齿，表现为对传统治疗有抵抗性的慢性上颌窦炎。曲霉菌血清学检查呈阴性或无显著意义，手术后可完全康复。侵袭性鼻-鼻窦曲霉菌病（INSA）影响身体虚弱的患者（糖尿病、免疫抑制、恶性血液病……），表现为骨质破坏，可蔓延至眼眶、颅底和颅内区域，病程呈急性或亚急性，曲霉菌血清学检查呈阳性。早期广泛的手术根除需结合局部和全身抗真菌治疗，但预后较差。较新描述的变应性鼻-鼻窦曲霉菌病（ANSA）将慢性鼻窦炎与严重的鼻-鼻窦息肉病以及特定的组织学和免疫学特征相结合。使用皮质类固醇治疗，其病程良好，但长期效果未知。
