腺样体肥大儿童分泌性中耳炎鼻窦炎的CT表现及其相关性

Correlation Between Pediatric Adenoid Hypertrophy and Nasosinusitis and Secretory Otitis Media: a Clinical Imageological Study

【目的】探讨腺样体肥大儿童伴分泌性中耳炎、鼻窦炎的CT表现及其相关性。【方法】对105例经临床手术病理证实为腺样体肥大且术前进行鼻咽部CT扫描(同时具有鼻窦炎或/和分泌性中耳炎)的临床影像学资料进行回顾性分析,根据腺样体肥大程度分为两组:中度肥大和重度肥大。分析两组间分泌性中耳炎和鼻窦炎发病率的差异性及影像学特征。【结果】中度肥大组CT表现为:上颌窦炎24例,筛窦炎17例,额窦炎3例,蝶窦炎例7例,鼻甲肥大30例,外耳道炎7例,鼓室炎23例,乳突窦炎23例;重度肥大组CT表现为:上颌窦炎46例,筛窦炎43例,额窦炎11例,蝶窦炎14例,鼻甲肥大44例,外耳道炎21例,鼓室炎44例,乳突窦炎44例。71%同时合并有鼻窦炎、分泌性中耳炎。【结论】腺样体肥大与分泌性中耳炎和鼻窦炎发病率呈正相关。重度肥大组分泌性中耳炎及鼻窦炎发病率明显高于中度肥大组,双侧发病率高于单侧。

[Objective]To investigate the correlation between the CT appearance of adenoid hypertrophy in children with nasosinusitis and secretory otitis media. [Methods]Nasopharyngeal CT images of 105 children with operation proved adenoid hypertrophy and nasosinusitis or/and secretory otitis media were retrospectively re- viewed. [Results]CT appearances of paranasal sinus and auris externa and auris media in group of moderate/severe adenoid hypertrophy included., maxillary sinusitis, ethmoiditis, frontal sinusitis, sphenoiditis, turbinal hypertrophy, external otitis, tympanitis and intramastoiditis. Seventy one percent of cases had both nasosinusitis and secretory otitis media simutaneously. [Conclusion]The severity of adenoid hypertrophy has a positive correlation with incidence of being complicated with nasosinusitis and secretory otitis media. The incidence of nasosinusitis and secretory otitis media in children with severe adenoid hypertrophy is much higher than that with moderate lesions. The incidence of multi-nasosinusitis and bilateral secretory otitis media is higher than mono-nasosinusitis and unilateral secretory otitis media in children with severe adenoid hypertrophy.