Advanced surgical technique for invasive fungal sinusitis: endoscopic orbit-sinus combined approach
Advanced surgical technique for invasive fungal sinusitis: endoscopic orbit-sinus combined approach
复制标题
侵袭性真菌性鼻窦炎的先进手术技术：内镜眼眶-鼻窦联合入路
DOI：
--
复制
发表时间：
2017
期刊：
影响因子：
--
通讯作者：
T. Ogawa
中科院分区：
文献类型：
--
作者：
K. Nishimura;Y. Takahashi;Y. Yamagishi;Shinya Banno;Y. Uchida;T. Tanigawa;M. Naito;H. Kakizaki;H. Ueda;T. Ogawa
摘要背景：侵袭性真菌性鼻窦炎通常预后不良，但目前尚无明确的手术治疗指南。在这里，我们报告的发展和应用内窥镜眶-窦联合入路（EOSCA），一种新的手术技术，同时进入鼻腔和眼眶，在侵袭性真菌性鼻窦炎与眼眶浸润的患者。材料和方法：2例侵袭性真菌性鼻窦炎患者接受了EOSCA。在切开睑结膜之前，进行经鼻内窥镜检查，以最大限度地减少鼻腔和眼眶中真菌浸润的组织。然后通过睑结膜切口将内窥镜插入眼眶，以从经鼻入路困难或不可能的眼眶区域去除已被真菌浸润的脂肪组织和肌肉。另一名外科医生通过经鼻腔同时操作内窥镜（四手技术）辅助手术。结果：我们能够安全和精确地切除病变，保留视力和功能性眼球。目前，患者均存活，无术后并发症、复发或毁容。结论：这种新的方法显示出作为一种安全可靠的手术方法，对侵袭性真菌性鼻窦炎浸润到眼眶的患者，没有术后并发症，复发或毁容。
Abstract Background: Invasive fungal sinusitis is usually associated with poor prognosis, but no clear guidelines have been established for surgical treatment. Here, we report the development and application of the endoscopic orbit-sinus combined approach (EOSCA), a novel surgical technique to approach the nasal cavity and orbit concurrently, in patients with invasive fungal sinusitis with orbital infiltration. Material and methods: Two patients with invasive fungal sinusitis infiltrating the orbit underwent EOSCA. Transnasal endoscopy was performed for maximum debulking of tissues infiltrated by fungi in the nasal cavity and orbit, before making an incision into the palpebral conjunctiva. An endoscope was then inserted into the orbit through the incision in the palpebral conjunctiva to remove adipose tissue and muscles that had been infiltrated by fungi from the orbital regions where the transnasal approach was difficult or impossible. Another surgeon assisted the procedure by operating an endoscope concurrently via the nasal cavity (four-hands technique). Results: We were able to remove lesions safely and with precision, preserving visual acuity and a functional eyeball in both cases. Currently, the patients are alive, with no postoperative complications, recurrence, or disfigurement. Conclusions: This novel method shows promise as a safe and reliable surgical procedure for patients with invasive fungal sinusitis infiltrating into the orbit, with no postoperative complications, recurrence, or disfigurement.
影响因子：
158.5
作者：
Walsh, TJ;Pappas, P;Lee, J
通讯作者：
Lee, J
影响因子：
158.5
作者：
Herbrecht, R;Denning, DW;de Pauw, B
通讯作者：
de Pauw, B