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1、非侵袭性真菌性鼻窦炎许雄辉方炜烨目录病因1临床表现2特征3诊断4治疗5病因真菌性鼻窦炎环境因素气候、职业全身因素糖皮质激素、免疫力低下局部因素鼻腔鼻窦通气引流障碍病原菌aspergillus、penicillium、moniliaClickToEditTitleStyleClassificationChronicinvasivefungalsinusitisAcutefulminantinvasivefungalsinusitisAllergicfungalsinusitisSinusfungalballInvasiveNon-invasiveSinusfungalballSequestr
2、ationoffungalelementswithinasinuswithoutinvasionorgranulomatouschangesgrowwhileevadinghostimmunesystem(noinvasion)AspergillusmostcommonspeciesMaxillarysinusmostofteninvolved(70-80%ofcases)DiagnosisCTScan:Singlesinusin59-94%ofcases(maxillary)CompleteorsubtotalopacificationofsinusBonysclerosis;destr
3、uctionisrare(3.6-17%ofcases)Biopsy=fungalelementsTreatmentCompletesurgicalremovaloffungalballIrrigationofinvolvedsinusesAntifungaltherapyOnlyifpatientishighriskforinvasivedisease(veryrare)SeverelyimmunocompromisedContinuedrecurrenceofdiseasedespitepropermedical/surgicalmanagementConsidertopicalant
4、ifungalirrigationfirstandthensystemictherapyifnoimprovementAllergicFungalSinusitisFungalcolonizationresultinginallergicinflammationwithoutinvasionDiagnosticCriteriaEosinophlicmucin(组织病理学黏蛋白)Nasalpolyposis（鼻息肉或哮喘）Radiographicfindings（典型影像学）Allergytofungi（对霉菌过敏）TreatmentSurgicalRemoveallmucinProvide
5、permanentdrainageandventilationofaffectedsinuses(鼻窦开放)Systemic+/-topicalsteroids（糖皮质激素）-ImmunotherapySOUCE杨秀敏,刘铭.100例真菌性鼻窦炎的病原菌分析[J].耳鼻咽喉:头颈外科,2000,7(1):9-13.李永奇.真菌性鼻窦炎的诊疗进展[J].国外医学:耳鼻咽喉科学分册,2003,27(3):162-166.薛康.鼻内镜手术治疗非侵袭性真菌性鼻窦炎42例[J].临床耳鼻咽喉头颈外科杂志,2008,22(17):804-805.张书文,孙士铭.真菌性鼻窦炎的CT与临床诊断[J].临床
6、放射学杂志,2002,21(10):778-780.GB/T7714刘铭,周兵,刘华超,等.变应性真菌性鼻窦炎[J].中华耳鼻咽喉科杂志,2002,37(3):169-172.周兵,刘铭,韩德民,等.变应性真菌性鼻窦炎CT影像特征[J].中华耳鼻咽喉头颈外科杂志,2006,41(7):493-496.钱进,孙建军,郭红光,等.CT检查在真菌性鼻窦炎术前诊断的意义[J].中国耳鼻咽喉头颈外科,2005,11(5):313-315.常京文,王晓珊,李声凯.鼻内镜手术治疗非侵袭性真菌性鼻窦炎[J].临床耳鼻咽喉头颈外科杂志,2008(20).李源,顾之燕.变应性真菌性鼻窦炎[J].见:顾之燕,韩
7、志刚,刘志连.耳鼻咽喉科变应性和免疫性疾病.天津:天津科学技术出版社,1999,53258.李鹏,刘贤,李源,等.咪康唑灌注在非侵袭性真菌性鼻窦炎手术后的应用[J].中国内镜杂志,2005,11(9):932-934.THANKYOU
