影像导航在辨别额隐窝气房中的价值

Evaluation of the frontal recess cells with image-guided system

目的:探讨影像导航对辨别额隐窝气房的价值。方法:收集2014-11-2015-12期间影像导航下内镜额窦开放手术资料30例,依据与额窦口的关系将额隐窝气房分为A组(位于额窦口下方的额隐窝气房)与B组(位于额窦口上方的额隐窝气房),采用视觉模拟量表评价影像导航对额隐窝气房定位辨别的需求程度,比较分析影像导航在辨别两组额隐窝气房的价值。结果:30例均顺利完成额窦开放术,各型额隐窝气房对影像导航的需求程度分别为:鼻丘气房、Ⅰ型额气房、Ⅱ型额气房、筛泡上气房为轻微需要;额泡气房、额窦间隔气房为一般需要;Ⅲ型额气房、Ⅳ型额气房、眶上筛房为明显需要。B组额隐窝气房较A组需要影像导航的程度高,组间差异有统计学意义(P<0.01)。结论:影像导航对Ⅲ型额气房、Ⅳ型额气房、眶上筛房、额窦间隔气房具有辨别价值,指导术中精确切除这些额隐窝气房有明显帮助。

Objective：To investigate the value of image-guided system in identifying the frontal recess cells.Method：We collected 30 cases that underwent image-guided frontal sinus surgery from November 2014 to December 2015.These frontal recess cells were devided into 2groups based upon their locations in the frontal sinus ostium.Group A consists of the agger nasi cells,type Ⅰfrontal cells,type Ⅱ frontal cells and suprabullar cells;group B consist of typeⅢfrontal cells,typeⅣfrontal cells,frontal bullar cells,interfrontal sinus septal cells and supraorbital ethmoid cells.Visual analogue scale（VAS）was used to evaluate the degree of demand of image guide system on the location of frontal recess cells,and then analyzed the value of image guided system on the frontal recess cells.Result：In all 30 patients the image-guided frontal sinus surgery was successfully completed.The demand degree of image-guided system on frontal recess cells by VAS was slight for the agger nasi cells,type Ⅰfrontal cells,typeⅡfrontal cells and suprabullar cells;the demand degree was general for the frontal bullar cells and interfrontal sinus septal cells;the demand degree was obvious for typeⅢfrontal cells,typeⅣfrontal cells and supraorbital ethmoid cells.Frontal recess cells of group B were more depended on image guided system than those of group A,and the difference was signicant（P〈0.01）.Conclusion：Image-guided system is valuable in distinguishing for typeⅢfrontal cells,typeⅣfrontal cells supraorbital ethmoid cells and interfrontal sinus septal cells.Furthermore,it is significantly helpful for accurate removal of these frontal recess cells in endoscopic frontal sinus surgery.