鼻咽癌放疗后继发慢性鼻-鼻窦炎的临床及影像学特征分析

Clinical and imaging characteristics of rhinosinusitis after radiotherapy in patients with nasopharyngeal carcinoma

目的探讨鼻咽癌(NPC)放疗后继发慢性鼻-鼻窦炎的临床及影像特征。方法对33例鼻咽癌患者放疗后继发慢性鼻-鼻窦炎进行鼻部主观症状视觉模拟量表(VAS)评分,鼻窦CT检查,并以Lund-Mackay评分法记录CT分值,同期选取33例单纯慢性鼻-鼻窦炎患者作为对照,并对记录的数据进行统计学分析。结果鼻咽癌放疗后继发慢性鼻-鼻窦炎组流涕或涕倒流VAS评分与单纯慢性鼻-鼻窦炎组相比,差异具有统计学意义(t=9.138,P<0.05);鼻咽癌放疗后继发慢性鼻-鼻窦炎组鼻窦CT的Lund-Mackay评分低于单纯慢性鼻-鼻窦炎组,主要原因在于额窦、上颌窦、前筛、窦口鼻道复合体的Lund-Mackay评分、累及率低于单纯慢性鼻-鼻窦炎组。结论鼻咽癌放疗后继发的慢性鼻-鼻窦炎病变特征与单纯慢性鼻-鼻窦炎不同,应采取不同的治疗策略。

Objective To study the clinical and imaging characteristics of rhinosinusitis after radiotherapy in patients with nasopharyngeal carcinoma（ NPC）. Methods 33 NPC patients with rhinosinusitis after radiotherapy（ group A） and 33 with common chronic rhinosinusitis（ group B） were included in this study. Visual analogue scale（ VAS） was used for evaluating subjective symptoms of the patients. Paranasal sinus CT was evaluated with Lund-Mackay scoring system. Results VAS score of nasal discharge or postnasal drip in group A was significantly higher than that in group B（ P〈 0. 05）. CT Lund-Mackay score in group A was lower than that in group B. The main reason lies in lower CT score and lower involvement rate of ostiomeatal complex,frontal sinus,maxillary sinus,anterior ethmoid sinus. Conclusions The characteristics of rhinosinusitis after radiotherapy in NPC patients are quite different from common chronic rhinosinusitis.And therefore,different therapeutic measures should be taken.