鼻丘及其邻近结构CT观察及其在内窥镜鼻窦手术中的作用

The CT scan of the agger cell and its adjacent structure in endoscopic paranasal sinus surgery

目的为了深入开展鼻内窥镜下额窦手术和鼻腔泪囊造口术等，观察鼻丘形态及其邻近结构的关系。方法采用鼻窦连续冠状和矢状位扫描，观察１００例患者（包括鼻中隔偏曲３０例，慢性鼻炎４０例，慢性鼻窦炎３０例），其中成人８０例，儿童２０例。结果①绝大多数病例（９９％）有鼻丘气房，儿童（９～１６岁）鼻丘发育与成人相比无差异性；②鼻丘形态变化很大，但与中鼻甲前端、筛泡和鼻泪管的关系是恒定的；③鼻丘向上气化程度与额窦发育关系密切，鼻中隔偏曲对其发育无明显影响；④前组鼻窦的广泛炎症易波及鼻丘，并可出现鼻丘骨质增厚。结论鼻丘为鼻内额窦手术和鼻腔泪囊造口术的进路，可借助鼻窦ＣＴ进行术前设计和预防并发症的发生。

Objective To promote the development of endoscopic frontal sinus surgery and naso lacrimal anastomosis surgery by studying the agger cells and their adjacent structures.Methods One hundred patients were observed by the continuous coronal CT scan and sagittal CT scan of the paranasal sinuses. Among them, 30 had deviation of nasal septum; 40 had chronic nasosinusitis. There were 80 adult and 20 children.Results (1)The agger cells existed in 99% of the cases, the development of the agger cells in 9～16 years old children, and adult had no difference; (2) The morphology of agger cells differed widely, but its relationship to the anterior border of the middle nasal concha, bulla ethmoidalis and nasolacrimal canal was quite stable; (3) The upward pneumatization of the agger cells was not related to deviation of nasal septum, but closely related to the development of the frontal sinus; (4) The anterior nasosinusitis often influenced the agger cells and might result in hyperosteogeny. Conclusion The agger cells situated at the pathway of the intranasal frontal sinus during surgery and dacryocystorhinostomy, the nasal CT scan might be beneficial to the prevention of surgical complications.