부비동의 국균증과 모균증

Abstract

Thirty-four cases of fungal sinusitis(29 cases of aspergillosis and 5 cases of mucormycosis) from March 1989 to February 1992 were investigated to analyze the predisposing factors, operative methods, accordance of involved sites between operative findings and computed tomogram of the paranasal sinuses, usefullness of antifungal agents and postoperative results. Eighty two percent of the paranasal fungal sinusitis occured in healthy individuals, and the radical surgery such as Caldwell-Luc operation was one of the most effective treatment modalities. The fungus ball was identified only in 55.2% of the aspergillosis. There were no recurrences in all cases except for cases with intracranial extension or systemic dissemination with the minimal follow-up of one year. Our experience indicates that the fungal sinusitis might occur mainly in healthy individuals rather than debilitating patients regardless of its pathogen and it could be efficiently treated with radical surgery alone. However, the antifungal agents should be combined in cases with intracranial extension or systemic dissemination with a limited effect. A new and more effective antifungal drug with minimal side effects should be anticipated.