鼻腔鼻窦解剖变异与慢性鼻窦炎的关系与手术处理方法的研究

Study on the Relationship between Anatomic Variations of Nasal Cavity and Paranasal Sinuses and Chronic Sinusitis,the Surgical Treatment

目的:研究鼻腔鼻窦解剖变异与慢性鼻窦炎的关系与手术处理方法的研究。方法:选择2014年1月至2016年12月在我院进行治疗的慢性鼻窦炎患者50名,经鼻窦CT检查结果对患者进行临床分期为Ⅰ型、Ⅱ型、Ⅲ型,采用全身麻醉或局部麻醉对患者进行鼻内镜手术治疗,观察并记录治疗后患者鼻中隔偏曲、下鼻甲肥大、鼻丘气房肥大、泡状中鼻甲、中鼻甲反向偏曲及钩突气化等鼻窦解剖变异情况。结果:术后,Ⅰ型总有效率100%,明显高于Ⅱ型87%及Ⅲ型总有效率66.7%差异显著(P<0.05)。结论:鼻中隔偏曲、下鼻甲肥大、鼻丘气房肥大、泡状中鼻甲、中鼻甲反向偏曲及钩突气化为构成鼻腔鼻窦解剖变异的主要因素,而鼻窦解剖变异与慢性鼻窦炎为相互影响的关系。

Objective： To study on the relationship between the anatomic variations of nasal cavity-paranasal sinuses and chronic sinusitis, the surgical treatment. Metliods： 50 patients of chronic sinusitis patients who received therapy from Jan 2014 to Dec 2016. The patients were divided into type Ⅰ , type Ⅱ and type Ⅲ by CT scan. The patients were treated with generaderwent nasal endoscopic sinus surgery. The anatomical variations of nasal sinuses were obsered and tion , inferior turbinate hypertrophy, nasal air hypertrophy,vesicular middle turbinate,reverse turbinate of middle turbinate and uncinateprocess. Results： After operation, the total effective rate of type I was 100%, which was significantly higher than that of type n 87% andtype Ⅲ 66. 7% （ P〈 0. 05）. Conclusion： Nasal septum deviation,inferior turbinate hypertrophy,nasal air middle turbinate, middle turbinate reverse biopsy and uncinate process gasification of the nasal cavity and paranasal sinus constitute the mainfactors of anatomical variation,sinus anatomic variation is a major cause of chronic sinusitis.