상악동 진균구의 범위에 따른 수술 후 결과 차이 (Comparison of Postoperative Results According to Fungus Ball Extension in Maxillary Sinus)

서지정보

· 발행기관 : 대한이비인후과학회
· 수록지 정보 : 대한이비인후-두경부외과학회지 / 64권 / 1호 / 13 ~ 18페이지
· 저자명 : 주여림, 변광현, 안정현, 최기용, 모지훈, 정영준

초록

Background and Objectives Fungus ball is the most common type of fungal sinusitis commonlyassociated with good prognosis. However, postoperative results depending on the extentof the lesion has not been investigated. This study aimed to identify differences in postoperativeresults depending on the location and extent of the fungus ball.
Subjects and Method Medical records of 165 patients who underwent endoscopic sinussurgery and who were diagnosed with fungus balls by biopsy from 2010 to 2019 were retrospectivelyreviewed. Patients were classified into four grades according to the location and extentof the fungus ball based on their endoscopic and CT findings. Poor outcome is defined asany pathologic signs such as nasal secretion, granulation, and polyps or narrowing of the naturalostium observed postoperatively according to Kennedy’s criteria, whereas good outcomeis defined as absence of pathologic signs.
Results A total of 23 patients were Grade 1, 38 Grade 2, 67 Grade 3, and 37 Grade 4. Grades1 and 2 were mostly asymptomatic. However, as the location of the fungus ball became closerto the natural ostium, patients complained postnasal drip and purulent discharge. Grades 3 and4, who have much severe and more extensive lesions than those of Grades 1 and 2, had pooroutcome (p=0.007) and took longer time to completely recover (p<0.001).
Conclusion Wound healing was delayed and poor when the fungus ball was located closer tothe natural ostium of the maxillary sinus. Therefore, preoperative consultation using endoscopicand CT findings could be useful for predicting their postoperative results.

영어초록

Background and Objectives Fungus ball is the most common type of fungal sinusitis commonlyassociated with good prognosis. However, postoperative results depending on the extentof the lesion has not been investigated. This study aimed to identify differences in postoperativeresults depending on the location and extent of the fungus ball.
Subjects and Method Medical records of 165 patients who underwent endoscopic sinussurgery and who were diagnosed with fungus balls by biopsy from 2010 to 2019 were retrospectivelyreviewed. Patients were classified into four grades according to the location and extentof the fungus ball based on their endoscopic and CT findings. Poor outcome is defined asany pathologic signs such as nasal secretion, granulation, and polyps or narrowing of the naturalostium observed postoperatively according to Kennedy’s criteria, whereas good outcomeis defined as absence of pathologic signs.
Results A total of 23 patients were Grade 1, 38 Grade 2, 67 Grade 3, and 37 Grade 4. Grades1 and 2 were mostly asymptomatic. However, as the location of the fungus ball became closerto the natural ostium, patients complained postnasal drip and purulent discharge. Grades 3 and4, who have much severe and more extensive lesions than those of Grades 1 and 2, had pooroutcome (p=0.007) and took longer time to completely recover (p<0.001).
Conclusion Wound healing was delayed and poor when the fungus ball was located closer tothe natural ostium of the maxillary sinus. Therefore, preoperative consultation using endoscopicand CT findings could be useful for predicting their postoperative results.

참고자료

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