中鼻甲高度和慢性鼻窦炎关系的研究

The CT study of relation between the height of middle concha and paranasal sinusitis

目的:研究中鼻甲高度和鼻窦炎的关系。方法:分析94例(185侧)经CT检查、手术和(或)临床证实的患者资料。将中鼻甲与半月裂的关系分为裂上型(中鼻甲下缘位于半月裂以上),裂口型(中鼻甲下缘位于半月裂水平至半月裂以下2mm以内)和裂下型(中鼻甲下缘位于半月裂以下部分大于2mm)。将不同中鼻甲高度、鼻中隔偏曲、中鼻甲气化、中鼻甲反向、钩突变异、筛大泡、Haller气房、鼻丘气房等解剖变异及各型鼻窦炎发生的侧数进行统计学分析。结果:裂上型+裂口型与裂下型比较,中鼻甲气化等解剖变异无统计学意义(P>0.05)。3种不同中鼻甲发育类型的各型鼻窦炎的发病率差异有统计学意义(P<0.01),裂上型和裂口型鼻窦炎的发生率高于裂下型(P<0.01),2、3型鼻窦炎(伴鼻息肉)的发生率亦高于裂下型(P<0.01),1型鼻窦炎的发生率与裂下型差异无统计学意义(P>0.05)。结论:中鼻甲高度变异的发生与鼻腔、鼻窦其他解剖变异无关;中鼻甲发育短小是鼻窦炎、鼻息肉发生的危险因素。

Objective：To evaluate the relation between the incidence of sinusitis and the position of the inferior border of the middle concha related to the semilunar hiatus. Method：Clinical data of 94 cases （185 sides of paranasal sinus） diagnosed by CT detection,operative findings and clinical features were analyzed. The middle concha was divided into 3 types according the position of its inferior border related to the semilunar hiatus ： superior hiatus type （the inferior border of the middle concha superior to the semilunar hiatus） , hiatus type （the inferior edge of the middle concha at the level of the semilunar hiatus） and inferior hiatus type （the inferior edge of the middle concha inferior to the semilunar hiatus）. Statistic analysis were taken for comparing the incidence of sinusitis among the position of the middle concha and other anatomical variations such as deviation of nasal septum, pneumatization of middle concha, paradoxical curve of the middle concha , variations ：of the uncinate process, ethmoidal bulla enlargements, Hailer cells and agger cell pneumatization. Result：There was no significant difference of the anatomic variations by comparing the superior hiatus type together with the hiatus type versus the inferior hiatus type（ P〉0.05）. But the incidence of sinusitis in each type was remarkably different, the superior hiatus type and hiatus type had more sinusitis than the inferior hiatus type. Furthermore, the second and third type of sinusitis in the superior hiatus type and hiatus type weighted over the inferior hiatus type（ P〈0.01）, while the first type didn＇t（ P〉0.05）. Conclusion：There is no association between the position of the middle concha and the anatomic variations of the nasal cavity and paranasal sinus. The poorly developed middle concha may acts as a risk factor for sinusitis and nasal polyps.