山东大学耳鼻喉眼学报 ›› 2016, Vol. 30 ›› Issue (2): 46-49.doi: 10.6040/j.issn.1673-3770.0.2015.432

• 论著 • 上一篇    下一篇

窦口鼻道复合体区解剖变异影像分析及与鼻-鼻窦炎的关系

邓玉琴,杨雅琪,陶泽璋,孔勇刚,许昱,陈始明   

  1. 武汉大学人民医院耳鼻喉科, 湖北 武汉 430060
  • 收稿日期:2015-10-19 出版日期:2016-04-16 发布日期:2016-04-16
  • 作者简介:邓玉琴. E-mail: bamboo0723@126.com通迅作者:陶泽璋. E-mail: taozezhang@hotmail.com
  • 基金资助:
    国家自然基金青年项目(81300813),武汉大学专项科研基金(302274669)

The relationship between the sinusitis and anatomic variations in ostiomeatal complex.

DENG Yuqin, YANG Yaqi, TAO Zezhang, KONG Yonggang, XU Yu, CHEN Shiming   

  1. Department of Otolaryngology, Wuhan University Peoples Hospital, Wuhan 430060, Hubei, China
  • Received:2015-10-19 Online:2016-04-16 Published:2016-04-16

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摘要： 目的 用高分辨率CT对鼻腔鼻窦炎进行影像学分析,探讨窦口鼻道复合体(OMC)区的解剖变异与儿童鼻窦炎、成人慢性鼻-鼻窦炎的关系。 方法 回顾性分析有明显临床表现且经CT扫描确诊为慢性鼻-鼻窦炎167例的临床资料,年龄4~74岁,并将其影像学资料分为儿童组和成人组,并对其分析结果进行比较。 结果 (1)儿童组和成人组的窦腔炎症最常累及上颌窦、前组筛窦和额窦;(2)儿童组的窦口鼻道复合体区解剖变异与慢性鼻-鼻窦炎的发生没有明显关系,而成人组的窦口鼻道复合体区解剖变异与慢性鼻-鼻窦炎的发生关系显著(P<0.05)。 结论 窦口鼻道复合体区的解剖变异对儿童慢性鼻-鼻窦炎的发生不如对成人的影响大,儿童慢性鼻-鼻窦炎的诊断和手术指征不能单凭异常的鼻窦CT扫描图作为惟一依据,应该切实联系临床症状。

关键词: 解剖变异, 儿童, 窦口鼻道复合体, 鼻窦炎

Abstract: Objective To analyze the characteristics of chronic paranasal sinusitis CT scans and to discuss the relationship between the anatomic variations in ostiomeatal complex(OMC)and the incidence of chronic pediatric sinusitis and adult sinusitis. Methods 167 cases of diagnosised chronic sinus were selected, age 4-74. The materials of image were divided into the childhood group and the adult group, then were analyzed. Results (1)The most commonly involved sinuses were maxillary sinuses, anterior ethmoids and frontal sinuses,both in the childhood group and the adult group. (2)The results showed no definitive correlation between bony anatomic variations and sinus in children but obvious relatioship between anatomic variations and adult sinus(P<0.05). Conclusion The influence of anatomic variations on the chronic pediatric sinusitis is more greater than on the adult sinusitis. The abnormal images of the sinus cannot stand alone as diagnostic evidence of pediatric sinusitis, it can serve only as confirmatory measures of sinus disease in patients whose clincal histories are supportive of the diagnosis.

Key words: Sinusitis, Anatomy, Ostiomeatal complex, Children

中图分类号: 

  • R765.2
[1] Longhini A B, Branstetter B F, Ferguson B J, et al. Radiology quiz case 1. Acute maxillary sinusitis secondary to a migrated dental implant obstructing the ostiomeatal complex[J].Arch Otolaryngol Head Neck Surg, 2011, 137(8):823, 826.
[2] Veskitkul J, Vichyanond P, Pacharn P, et al.Clinical characteristics of recurrent acute rhinosinusitis in children[J]. Asian Pac J Allergy Immunol, 2015, 33(4):276-280.
[3] Haruna S, Sawada K, Nakajima T, et al.Relationship between pediatric sinusitis and middle turbinate pneumatization-ethmoidal sinus pyocele thought to be caused by middle turbinate pneumatization[J]. Int J Pediatr Otorhinolaryngol, 2005, 69(3):375-379.
[4] Poorey V K, Gupta N.Endoscopic and computed tomographic evaluation of influence of nasal septal deviation on lateral wall of nose and its relation to sinus diseases[J].Indian J Otolaryngol Head Neck Surg, 2014, 66(3):330-335.
[5] 孙国龙.探讨CT扫描在儿童鼻窦炎与窦口鼻道复合体关系中的应用价值[J]. 中外医学研究, 2014, 2(12):61-63.
[6] Eryilmaz A, Gocer C, Dursun E, et al.The incidence of anatomic variations and sinus opacities in pediatric patients with chronic sinonasal symptoms[J].Kulak Burun Bogaz Ihtis Derg, 2004,13(5-6):116-121.
[7] Sivasli E, Sirikci A, Bayazyt Y A, et al. Anatomic variations of the paranasal sinus area in pediatric patients with chronic sinusitis[J]. Surg Radiol Anat, 2003, 24(6):400-405.
[8] Haruna S, Sawada K, Nakajima T, et al.Relationship between pediatric sinusitis and middle turbinate pneumatization-ethmoidal sinus pyocele thought to be caused by middle turbinate pneumatization[J].Int J Pediatr Otorhinolaryngol,2005,69(3):375-379.
[9] 中华耳鼻咽喉头颈外科杂志编委会,中华医学会耳鼻咽喉头颈外科学分会鼻科学组.慢性鼻-鼻窦炎诊断和诊疗指南(2012年,昆明)[J].中华耳鼻咽喉头颈外科杂志,2013,48(2):93-94.
[10] Zeifer B. Pediatric sinonasal imaging: normal anatomy and inflammatory disease[J].Neuroimaging Clin N Am, 2000,10(1):137-159.
[11] 许庚,史剑波. 儿童鼻窦炎规范化诊断和治疗[J]. 中国耳鼻喉头颈外科, 2005,7:407-410.
[12] 孟玮,周维国,李光飞,等.伴发儿童鼻窦炎的阻塞性睡眠呼吸暂停低通气综合征患儿手术疗效分析[J].临床耳鼻咽喉头颈外科杂志,2014,28(7):462-464. MENG Wei, ZHOU Weiguo, LI Guangfei, et al. The analysis of surgery effect of OSAHS children acompanied with sinusitis[J]. J Clin Otorhinolaryngol Head Neck Surgery, 2014, 28(7):462-464.
[13] Lieser J D, Derkay C S. Pediatric sinusitis: when do we operate? [J]. Curr Opin Otolaryngol Head Neck Surg, 2005, 13(1):60-66.
[14] Ramadan H H. Surgical management of chronic sinusitis in children[J].Laryngoscope, 2014, 114(12):2103-2109.
[15] 陶泽璋,黄小林,华清泉,等. 青少年鼻中隔成形术[J].中华耳鼻咽喉科杂志,2001,6(3):223.
[16] 孙晓卫,窦芬芬,李文杰,等.1~12岁儿童鼻中隔偏曲发生率与鼻窦炎相关性的 CT 研究[J]. 临床耳鼻咽喉头颈外科杂志,2015, 29(20):1770-1772. SUN Xiaowei, DOU Fenfen, LI Wenjie, et al. Study on the correlation between nasal septum deviation and sinusitis based on CT scan among 1-12 years old children[J]. J Clin Otorhinolaryngol Head Neck Surgery, 2015, 29(20):1770-1772.
[17] Subcommittee on Management of Sinusitis and Committee on Quality Improvement. Clinical practice guideline: management of sinusitis[J]. Pediatrics, 2001, 108(3):798-808.
[18] Shpilberg K A, Daniel S C, Doshi A H, et al. CT of anatomic variants of the paranasal sinuses and nasal cavity: poor correlation with radiologically significant rhinosinusitis but importance in surgical planning[J]. Am J Roentgenol, 2015, 204(6):1255-1260.
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