目的：观察鼻内镜下上颌窦口开放联合泪前隐窝入路治疗真菌性上颌窦炎的疗效。方法真菌性上颌窦炎61例，27例行鼻内镜下上颌窦口开放联合泪前隐窝入路术式（观察组），34例行鼻内镜下单纯上颌窦口开放术式（对照组），术后随访1～2年，比较2种手术径路对真菌性上颌窦炎的疗效。结果治疗组治愈率为81.5%(22/27)，好转率为11.1%(3/27)，无效率为7.4%(2/27)；对照组治愈率58.8%(20/34)，好转率为14.7%(5/34)，无效率26.5%(9/34），组间疗效差异有统计学意义（P＜0.05）。结论鼻内镜下上颌窦口开放联合泪前隐窝入路术式视野清晰，能全方位暴露上颌窦窦腔各死角，有利于清除病变组织，提高治愈率。%Objective To evaluate the therapeutic effect of combined apertura maxillaris opening with anterior nasolacrimal recess approach on fungal maxillary sinusitis.Methods Included in this study were 61 cases with fungal maxillary sinusitis divided into 2 groups, with 27 in treatment group (TG) and 34 in control group (CG). Cases in TG were treated by combined apertura maxillaris opening procedure with anterior nasolacrimal recess approach under nasal endoscope, while those in CG treated by apertura maxillaris opening approach only, also under nasal endoscope. All these patients were followed up for one to two years to observe their therapeutic effect of the surgical procedures.Results It was found by the end of following up period that the curative rate was 81.5% (22/27), effective rate was 11.1% (3/27) and ineffective rate was 7.4% (2/27) for those in TG, while these rates were 58.5%, 14.7%, and 26.5% respectively for ones in CG, with significantly statistical significance between them (P<0.05).Conclusions Combined apertura maxillaris opening with anterior nasolacrimal recess approach is a better way to deal with fungal maxillary sinusitis, with the cavity of maxillary sinus exposed clearly and pathological tissues removed easily to improve therapeutic effect and reduce reocurring chance of such a condition.
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