中鼻甲形态和慢性鼻窦炎关系的初步探讨

The relationship between anatomical characteristics of middle turbinate and chronic sinusitis

目的探讨中鼻甲形态(垂直部上下径的长度、中鼻甲气化、反向偏曲)与慢性鼻窦炎的相关性,为术中处理中鼻甲提供参考依据和理论基础。方法通过结合螺旋CT检查和鼻内镜检查结果,对106例慢性鼻窦炎患者、50例健康志愿者的资料进行对比分析,测量中鼻甲垂直部上下径的长度,观察结构变异情况。结果慢性鼻窦炎组中鼻甲长度为左(23.62±3.28)mm、右(24.22±3.64)mm;对照组中鼻甲长度为左(21.30±3.19)mm、右(21.42±2.81)mm,差异均有统计学意义(P<0.01)。两组鼻中隔偏曲发生率的差异有统计学意义(P<0.05),而中鼻甲反向和气化发生率的差异无统计学意义(P>0.05)。结论中鼻甲垂直部的长度、鼻中隔偏曲与慢性鼻窦炎的发病可能有关;中鼻甲垂直部过长可能也是导致鼻窦炎发生发展的原因之一,术中可根据中鼻甲的实际长度和变异情况适当处理。

Objective To explore the relationship between anatomical middle turbinate （MT） characteris ties （the vertical--segment length, MT pneumatization, reverse deviation） and chronic sinusitis, and providing the reference frame and theoretical basis for managing MT during operation. Methods The outcomes of spi- nal CT coronal scanning and nasal endoscopy for 106 patients with chronic sinusitis and 50 healthy volunteers were comparatively analyzed. The length of middle turbinate in the vertical segments was measured, the struc- tural variations of nasal were observed. Results The average vertical -- segment length of middle turbinate were （23.62±3.28） mm（left） and （24. 22±3. 64） ram（right） in chronic sinusitis group, while those were （21.30±3.19） mm（left） ,（21.42±2.81） mm（right） in healthy volunteers group, and compared chronic sinus- itis group to healthy volunteers group, there were statistically significant differences （ P 〈0.01）. In compari- son of nasal septum deviation incidence between the two groups, there were statistically significant differences （ P 〈0.05）. The differences of middle turbinate contraflexure and bullosa incidences between the two groups were not statistically significant （ P 〉0.05）. Conclusion The vertical length of middle turbinate and devia- tion of nasal septum may have positive relationship with incidence of chronic sinusitis. The over--length of middle turbinate in vertical segments may play an important role in the genesis and development of chronic si- nusitis;the middle turbinate should be managed appropriately during operation on the basis of physical length and variations.