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상악동 진균구의 범위에 따른 수술 후 결과 차이

Comparison of Postoperative Results According to Fungus Ball Extension in Maxillary Sinus

주여림, 변광현, 안정현, 최기용, 모지훈, 정영준,
소속 상세정보
주여림 ( Ju Yeo-Rim ) - Dankook University College of Medicine Department of Otorhinolaryngology-Head and Neck Surgery
변광현 ( Byun Kwang-Hyun ) - Dankook University College of Medicine Department of Otorhinolaryngology-Head and Neck Surgery
안정현 ( Ahn Jung-Hyun ) - Dankook University College of Medicine Department of Otorhinolaryngology-Head and Neck Surgery
최기용 ( Choi Ki-Yong ) - Dankook University College of Medicine Department of Otorhinolaryngology-Head and Neck Surgery
모지훈 ( Mo Ji-Hun ) - Dankook University College of Medicine Department of Otorhinolaryngology-Head and Neck Surgery
정영준 ( Chung Young-Jun ) - Dankook University College of Medicine Department of Otorhinolaryngology-Head and Neck Surgery

Abstract


Background and Objectives: Fungus ball is the most common type of fungal sinusitis commonly associated with good prognosis. However, postoperative results depending on the extent of the lesion has not been investigated. This study aimed to identify differences in postoperative results depending on the location and extent of the fungus ball.

Subjects and Method: Medical records of 165 patients who underwent endoscopic sinus surgery and who were diagnosed with fungus balls by biopsy from 2010 to 2019 were retrospectively reviewed. Patients were classified into four grades according to the location and extent of the fungus ball based on their endoscopic and CT findings. Poor outcome is defined as any pathologic signs such as nasal secretion, granulation, and polyps or narrowing of the natural ostium observed postoperatively according to Kennedy’s criteria, whereas good outcome is 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. Grades 1 and 2 were mostly asymptomatic. However, as the location of the fungus ball became closer to the natural ostium, patients complained postnasal drip and purulent discharge. Grades 3 and 4, who have much severe and more extensive lesions than those of Grades 1 and 2, had poor outcome (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 to the natural ostium of the maxillary sinus. Therefore, preoperative consultation using endoscopic and CT findings could be useful for predicting their postoperative results.

키워드

Fungus ball; Maxillary sinus; Wound healing

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