鼻中隔偏曲伴下鼻甲肥大患者的鼻窦CT分析

Analysis of inferior turbinate in patients with deviated nasal septum by using computed tomography

目的通过对鼻中隔偏曲患者鼻窦CT的测量分析,初步评价鼻中隔偏曲程度与下鼻甲肥大的相关性。方法分析98例鼻中隔偏曲患者鼻窦冠状位CT,将与鼻中隔偏曲方向一致的鼻腔设为对照组,与鼻中隔偏曲方向相反的鼻腔设为实验组。测量并记录鼻中隔偏曲角度,双侧下鼻甲骨、内侧黏膜、外侧黏膜厚度。结果实验组和对照组下鼻甲内侧黏膜、骨、外侧黏膜厚度差异有统计学意义(P<0.05)。实验组下鼻甲内侧黏膜、骨、外侧黏膜厚度差异有统计学意义(P<0.05)。实验组下鼻甲内侧黏膜、骨、外侧黏膜厚度与鼻中隔偏曲角度的相关性无统计学意义,但相关系数r提示三者与鼻中隔偏曲角度的相关性:骨>内侧黏膜>外侧黏膜。结论鼻中隔偏曲伴代偿性下鼻甲肥大,不仅由下鼻甲黏膜增厚引起,也可由下鼻甲骨本身增生引起,鼻中隔矫正术术前行鼻窦CT检查,对鼻中隔偏曲伴下鼻甲肥大患者手术方式的选择有一定帮助。

OBJECTIVE To evaluate the relationshipbetween the degree of nasal septum deviation and inferior turbinate hypertrophy with the CT. METHODS The paranasal sinus CTs of 98 cases with septum deviation were evaluated. Inferior turbinate on the deviated side of the nasal septum was considered as the control group and the inferior turbinate on the other side was taken as the study group in the same patient. The septal deviation angle, thickness of the bone, medial mucosa and lateral mucosa of the inferior turbinate were measured. RESULTS The thickness of the bone, medial mucosa and lateral mucosa of the inferior turbinate were statistically different between the study group and the control group（P〈0.05）. There were statistically differences between the medial and lateral mucosal thickness in study group（P〈0.05）. There was no positive correlation between the deviation angle and the thickness bone, medial and lateral mucosa of the inferior turbinate in the study group（P〉0.05）, but the value of correlation coefficents revealed the inferior turbinate bone correlated with the deviation angle most, followed by medial and lateral mucosal thickness. CONCLUSION The hypertrophy of inferior turbinate in patients with nasal septum deviation is not only caused by mucosal hypertrophy, but also by hypertrophy of the inferior turbinate bone. The preoperative CT before septoplasty can be helpful to choose the surgical methods during the operation.