蝶竇麴菌感染的病例非常少見,根據文獻上的記載只發現14例。病人通常有頭痛或視覺障礙的病史。臨床上病人的主訴,多於蝶竇的擴大致壓迫其週邊的構造而來。 本文報告之二例蝶竇麴菌感染以頭痛及視覺障礙為主訴。理學檢查顯示一例有兩顳側偏盲,另一例有左眼皮下垂,電腦斷層攝影,兩例皆見在蝶竇有一擴大的低密度區,並有向上侵犯到蝶鞍。 這兩例經初步診斷為蝶竇腫瘤而接受了經上齒齦蝶竇顯微手術。術中可見一鼓起之蝶竇腫塊,打開後有大量灰綠色膿液流出。病理檢查確定為麴菌感染。於術後有一例接受抗黴菌藥物治療。 這二例於術後頭痛及視覺都獲得很大的改善。
Tow cases of sphenoid sinus aspergillosis underwent surgical intervention via the transsphenoidal approach to the sphenoid sinus cavity with good results in both cases. Adjunctive systemic antifungal therapy with amphotericin B was used in one case. The headache and visual disturbance improved postoperatively and no obious neurological sequelae were encountered.