Objective To explore the clinical and imaging characteristics of fungal sphenoid sinusitis and to evaluate the clinical effect of nasal endoscopy surgery. Methods The clinical data of 67 patients admitted to the department of Otonolaryngosis Head and Neck Surgery of the following hospitals from January 2008 to January 2018 were retrospectively analyzed (the PLA Joint Service Protection Force 909 Hospital, Longhai City First Hospital and the Affiliated to the Naval Military Medical University). The clinical and imaging characteristics of the 67 patients with fungal sphenoid sinus invasion and sphenoid sinus were summarized. All patients received endoscopic sphenoid sinus opening and lesions removal surgery, and were followed up for 6 months to 12 months to evaluate the surgical efficacy. Visual analog scale (VAS) was used for subjective disease assessment, while the Lund-Kennedy scoring was used for objective disease. The differences between preoperative and postoperative 3, 6 and 12 months were compared. Results All 67 cases were cured by one operation, and none of them had serious complications after surgery. The VAS score was (8.34±1.36) preoperatively, but decreased continuously. The VAS score of 3, 6, 12 months after surgery were (2.45±1.06) points, (1.65±1.24) points, (1.21±0.66), respectively. Lund-Kennedy's score was (8.42±1.16) before surgery, but decreased to (2.56±0.86), (1.74±1.16), (1.15±0.76) at 3, 6, 12 months after surgery, respectively. There were statistical differences in the VAS score and Lund-Kennedy's score before and after surgery (P<0.001). Conclusions The main symptoms of fungal sphenoid sinusitis is headache without any regularity. Endoscopic examination showed mucosal edema in the sphenoidal crypt, and there are caseous and mucinous secretions at the sinus orifice. CT images are characterized by uneven soft tissue density shadow in the sphenoidal sinus cavity, with high-density plaque-like calcification shadow, and thickening of the bone in sinus wall. According to different ranges of lesions, it is a simple, safe and effective method to treat fungal sphenoid sinusitis with the whole hemp nasal endoscopy and nasal endoscopy-assisted surgical treatment.
Key words
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Sphenoid sinus /
Fungal lesions /
Clinical features /
Endoscopy /
Surgery
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