鼻内镜鼻窦手术前筛窦颅底高度的CT评估价值

doi:10.6040/j.issn.1673-3770.0.2018.322

摘要/Abstract

摘要： 目的探讨内镜鼻窦手术前应用CT评估筛窦颅底高度的价值。方法选取就诊于我院的100例共200侧的鼻窦冠状CT扫描图像,测量筛前动脉水平的筛顶中点至眶水平中线的距离,根据测量数据进行分型,同时进行Keros分型,用皮尔森相关系数来确定两者之间是否存在相关性。结果筛前动脉管水平的筛顶中点至眶水平中线的距离作为筛窦颅底高度。根据筛窦颅底的高度进行分型,其中Ⅰ型即筛窦颅底高度>7 mm(高位颅底)占44%(88/200),Ⅱ型即筛窦颅底高度介于4~7 mm(中位颅底)占41%(82/200),Ⅲ型即筛窦颅底高度<4 mm(低位颅底)占15%(30/200)。按Keros方法进行测量并分型,Ⅰ型占37%(74/200),Ⅱ型占52%(104/200),Ⅲ型占11%(22/200);Keros分型与筛窦颅底高度之间的皮尔森相关系数为0.384(P<0.001),Keros分型与筛窦颅底高度呈弱相关性。结论筛窦颅底高度存在明显差异,术前进行CT影像评估,可有效识别低颅底变异,有助于避免颅底损伤,进而减少内镜手术并发症。

关键词: 筛窦, 颅底, 并发症, 鼻窦炎, 内镜手术, 鼻窦

Abstract: Objective To explore the procedure of computed tomography(CT)and evaluate its clinical value in evaluating the height of the ethmoidal sinus skull base before endoscopic sinus surgery. Methods A total of 100 patients with coronal CT scans of the sinuses(200 sides)were selected in our hospital for measurement of the distance between the mid-point of the sieves and the mid-line of the orbital level of the anterior ethmoid artery. The sinuses were classified using the Keros classification, and the correlation between the Keros classification and the height of the ethmoid sinus base was determined using the Pearson correlation coefficient. Results The distance between the top of the ethmoidal artery from the anterior ethmoid artery to the midline of the orbital level was the height of the base of the ethmoid sinus. According to the height of the ethmoidal sinus skull base, 44%(88/200)were type Ⅰ(more than 7 mm, high skull base), 41%(82/200)were type Ⅱ(4-7 mm, middle skull base), and 15%(30/200)were type Ⅲ(less than 4 mm, low skull base). According to the Keros classification, type Ⅰ accounted for 37%(74/200), type Ⅱ for 52%(104/200), and type Ⅲ for 11%(22/200)of the sinuses; the Pearson correlation coefficient between Keros classification and ethmoidal sinus skull base height was 0.384(P<0.001), which indicated a weak correlation. Conclusion The height of the ethmoidal sinus skull base is significantly different. Pre-operative CT imaging evaluation can effectively identify low skull base variations to help avoid skull base injury, and thus reduce the complications of endoscopic surgery.

Key words: Sinusitis, Ethmoid sinus, Complication, Skull base, Endoscopic surgery, Paranasal sinuses

中图分类号:

R765.41

张汝祥,田昊,马有祥. 鼻内镜鼻窦手术前筛窦颅底高度的CT评估价值[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 75-77.

ZHANG Ruxiang, TIAN Hao, MA Youxiang. Computed tomography assessment of skull base height before endoscopic sinus surgery[J]. J Otolaryngol Ophthalmol Shandong Univ, 2018, 32(5): 75-77.

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