Choice of Intranasal Endoscopic Minimally Invasive Surgeries for Non-invasive Fungal Maxillary Sinusitis

Objective To compare the curative efficacy of three different intranasal endoscopic minimally invasive surgeries for non-invasive fungal maxillary sinusitis,and analyze the clinical significance of cavity lavage with fluconazole.Methods The clinical data of 284 hospitalized patients with non-invasive fungal maxillary sinusitis were retrospectively analyzed from January 2006 to December 2010.Under sinus endoscopy,patients were grouped based on different surgeries including maxillary sinus ostium opening(group A),maxillary sinus ostium combined with anterior wall opening of the maxillary sinus via lip gingival sulcus(group B),and maxillary sinus ostium combined with inferior meatus opening(group C).After surgical treatment,patients in the three groups received either normal saline or fluconazole repeatedly flushing the nasal cavity and the maxillary sinus.All patients were followed up for at least six months.Results There were 51,45,and 188 patients in group A,group B and group C,respectively.Among them,there were 15 cases in group A,9 in group B,and 6 in group C with disease recurrence,and the recurrence rate was 29.6%,20% and 3.2%,respectively.The recurrence rate in group C was significant lower than that in group A and B(both P0.05).Among patients in group C,the wound healing time for patients receiving saline or fluconazole repeatedly flushing the nasal cavity and the maxillary sinus was 3.8 weeks and 3.7 weeks,respectively;and the difference was not significant(P0.05).Conclusion Maxillary sinus ostium combined with inferior meatus opening under sinus endoscopy is the best treatment strategy for non-invasive fungal maxillary sinusitis;and the wound healing time is independent of the type of irrigation fluid.