Sabini P, Josephson G D, Reisacher W R, Pincus R
Department of Otolaryngology Head and Neck Surgery, The New York Eye and Ear Infirmary, NY, USA.
Am J Otolaryngol. 1998 Nov-Dec;19(6):351-6. doi: 10.1016/s0196-0709(98)90035-7.
Increasingly, otolaryngologists are treating patients with acquired immunodeficiency syndrome (AIDS) who suffer from associated sinusitis refractory to medical therapy. Despite this trend, few reports in the literature detail the mode of surgical therapy, pathogens, and outcome in this patient population. Our aim in this study was to describe our experience in treating these patients, with particular attention to surgical outcome and pathogens.
We reviewed our experience with performing sinus surgery in 33 AIDS patients. Endoscopic sinus procedures were performed in 24 patients, while the remaining nine patients underwent nasal antral windows and/or Caldwell-Luc operations. Follow-up information was obtained in 16 of the 24 patients who underwent endoscopic sinus surgery.
At an average follow-up time of 16 months, 14 of the endoscopic sinus surgery patients reported improvement from their preoperative condition. Thirty-seven pathogens were identified in 23 patients. A larger percentage of nontraditional pathogens was found in these patients, which suggests a larger role for microbiologic diagnosis and treatment versus empiric therapy.
Patients with AIDS and chronic sinusitis may benefit from endoscopic sinus procedures.
越来越多的耳鼻喉科医生在治疗患有获得性免疫缺陷综合征（AIDS）且伴有药物治疗无效的鼻窦炎患者。尽管有这种趋势，但文献中很少有报道详细描述该患者群体的手术治疗方式、病原体及治疗结果。我们这项研究的目的是描述我们治疗这些患者的经验，尤其关注手术结果和病原体。
我们回顾了对33例艾滋病患者进行鼻窦手术的经验。24例患者接受了内镜鼻窦手术，其余9例患者接受了鼻上颌窦开窗术和/或柯-陆氏手术。对接受内镜鼻窦手术的24例患者中的16例获得了随访信息。
平均随访16个月时，14例接受内镜鼻窦手术的患者报告其病情较术前有所改善。在23例患者中鉴定出37种病原体。在这些患者中发现非传统病原体的比例更高，这表明微生物诊断和治疗相对于经验性治疗的作用更大。
患有艾滋病和慢性鼻窦炎的患者可能从内镜鼻窦手术中获益。
