Functional endoscopic sinus surgery (FESS) in unilateral sinus disease.
Functional endoscopic sinus surgery (FESS) in unilateral sinus disease.
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DOI：
10.5604/01.3001.0010.5314
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发表时间：
2017-10-30
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影响因子：
--
通讯作者：
Rybak-Korytowska, Aleksandra
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文献类型：
--
作者：
Mielcarek-Kuchta, Daniela;Simon, Karolina;Rybak-Korytowska, Aleksandra
背景：单侧鼻窦疾病（USD）发生在所有病例的23%。据信，它主要与癌症的发展有关。回顾性数据显示，从大型病理学中心，最常见的美元是慢性鼻窦炎（CRS），其次是真菌病，内翻性乳头状瘤，最后是癌症，但只有在一小部分cases. The目的的研究：分析美元的一组病人谁接受FESS在二级转诊中心。材料和方法：对2014年6月至2016年6月期间在波兹南省医院耳鼻喉科接受USD治疗的患者进行的回顾性研究。分析包括年龄，性别，病变部位，组织病理学和微生物学结果，手术和治疗结果的扩展。结果：在分析的时间内，415 FESS慢性鼻窦炎进行。在该组中，83名患者接受了USD手术。其中女性35例，男性48例。48例发现CRS，9例发现真菌病，12例患者因非恶性肿瘤接受手术，如内翻性乳头状瘤（9例）、骨瘤（2例）和纤维化肿瘤（1例）; 7名患者患有后鼻孔息肉，其中2名患者上颌窦异物--牙根松动。4例患者被诊断为上颌窦发育不良，1例患者患有额窦脓囊肿。一侧内窥镜开放的所有鼻窦中进行的CRS组，内窥镜内侧上颌骨切除术进行内翻性乳头状瘤的患者，和一个孤立的开放的受影响的鼻窦真菌病的情况下进行。结论：USD必须始终怀疑恶性变性，直到证明否则。使用成角镜的内窥镜鼻窦手术允许切除甚至非常广泛的病变。我们认为，手术的范围取决于病理的性质。内翻性乳头状瘤患者建议进行广泛的手术，而孤立性真菌病患者则应进行有限的手术。
BACKGROUND: Unilateral sinus disease (USD) occurs in 23 % of all cases. It is believed that it is mainly associated with cancer development. Retrospective data from large rhinological centers show that the most common USD is chronic rhinosinusitis (CRS), followed by mycosis, inverted papilloma and finally cancer, but only in a small percent of cases.THE AIM OF THE STUDY: The analysis of USD in the group of patients who underwent FESS at the secondary referral center.MATERIAL AND METHOD: The retrospective study of patients treated for USD in the Department of Otolaryngology in the Provincial Hospital in Poznan between June 2014 and June 2016. The analysis includes age, sex, the localization of lesions, histopathological and microbiological results, an extension of the surgery and treatment results.RESULTS: Over the analyzed period of time, 415 FESS for chronic sinusitis were performed. In this group, 83 patients underwent surgery for USD. There were 35 women and 48 men.CRS was found in 48 cases, mycosis in nine cases, 12 patients were operated for non-malignant tumors, such as inverted papilloma (9), osteoma (2) and fibrosis tumor(1); seven patients had a choanal polyp and two of them had a foreign body in maxillary sinus - a tooth root lying loose. Four patients were diagnosed with a hypoplastic maxillary sinus and one patient suffered from frontal sinus pyocele. One side endoscopic opening of all sinuses was performed in the group with CRS, endoscopic medial maxillectomy was conducted in patients with inverted papilloma, and an isolated opening of the affected sinus was performed in the cases with mycosis.CONCLUSIONS: USD must be always suspected of malignant degeneration until proven otherwise. Endoscopic sinus surgery with the use of angled scope allows for the removal of even very extensive lesions. In our opinion, the extent of operation is determined by the nature of pathology. While extensive surgery is recommended in patients with inverted papilloma, a limited procedure should be performed in those with isolated mycosis.