螺旋CT三维重建技术在唇腭裂继发鼻腔畸形患者中的应用价值

Application value of spiral CT three-dimensional reconstruction technique in patients with nasal cavity deformity secondary to cleft lip and palate

目的探讨螺旋CT三维重建技术对唇腭裂继发鼻腔畸形患者畸形特征的评估价值。方法应用螺旋CT设备分别对2018年3月至2021年10月某院收治的43例唇腭裂继发鼻腔畸形患者(研究组)及45例鼻唇部正常者(对照组)行颌面部螺旋CT检查,并运用Mimics17.0影像处理软件对影像资料进行三维重建处理,测量并比较其鼻部解剖形态,分析评估其鼻腔畸形特征。结果研究组43例唇腭裂继发鼻腔畸形患者平均鼻腔总体积为(14.54±2.38)cm^(3),其中患侧平均鼻腔体积为(6.57±1.49)cm^(3),健侧为(7.97±1.52)cm^(3),患侧鼻腔体积明显小于健侧,差异有统计学意义(t=4.313,P<0.05);研究组患者平均鼻腔总体积明显小于对照组,差异有统计学意义(t=3.333,P<0.05)。研究组患者平均鼻黏膜表面积为(143.19±24.27)cm^(2),其中患侧平均鼻黏膜表面积为(66.14±12.48)cm^(2),健侧为(77.05±13.71)cm^(2),患侧鼻黏膜表面积明显小于健侧,差异有统计学意义(t=3.859,P<0.05);研究组患者平均鼻黏膜表面积明显小于对照组,差异有统计学意义(t=3.435,P<0.05)。研究组患者鼻黏膜表面积与鼻腔体积比值大于对照组,差异有统计学意义(t=5.335,P<0.05)。研究组患者鼻道存在明显畸形,呈鼻道中部向患侧,两端向健侧的“月形”畸形,且鼻阈区明显后移伴狭窄,鼻底下沉。结论唇腭裂继发鼻腔畸形患者鼻腔形态明显与健康人存在差异,螺旋CT三维重建技术可有效展现鼻道结构,直观地观察鼻道位置及走向,为临床整形修复手术提供可靠数据支持,具有较高临床应用价值。

Objective To explore the evaluation value of spiral CT three-dimensional reconstruction technology in the evaluation of the deformity characteristics of patients with nasal cavity deformity secondary to cleft lip and palate.Methods Spiral CT equipment was used to perform maxillofacial spiral CT on 43 patients with cleft lip and palate secondary to nasal cavity deformity(study group)and 45 patients with normal nasolabial region(control group)admitted to a hospital from March 2018 to October 2021.Check,and use Mimics17.0 image processing software to perform three-dimensional reconstruction processing on the image data,measure and compare its nasal anatomy,analyze and evaluate its nasal cavity deformity characteristics.Results The average total nasal cavity volume of 43 patients with nasal cavity deformity secondary to cleft lip and palate in the study group was(14.54±2.38)cm^(3),of which the average nasal cavity volume of the affected side was(6.57±1.49)cm^(3),the healthy side was(7.97±1.52)cm^(3),and the nasal cavity of the affected side was(7.97±1.52)cm^(3) The volume was significantly smaller than the healthy side,and the difference was statistically significant(t=4.313,P<0.05);the average total nasal cavity volume of patients in the study group was significantly smaller than that of the control group,and the difference was statistically significant(t=3.333,P<0.05).The average nasal mucosal surface area of the patients in the study group was(143.19±24.27)cm^(2),of which the average nasal mucosal surface area of the affected side was(66.14±12.48)cm^(2),and the contralateral side was(77.05±13.71)cm^(2).The surface area of the nasal mucosa of the affected side was significantly smaller than that of the healthy side.The difference was statistically significant(t=3.859,P<0.05);the average surface area of the nasal mucosa of the study group was significantly smaller than that of the control group,and the difference was statistically significant(t=3.435,P<0.05).The ratio of the surface area of the nasal mucosa to the volume of the nasal cavity in the study group was greater than that in the control group,and the difference was statistically significant(t=5.335,P<0.05).The nasal passages of the patients in the study group had obvious malformations,which were"moon-shaped"malformations with the middle of the nasal passage facing the affected side and both ends toward the healthy side,and the nasal threshold area was significantly shifted back with stenosis,and the base of the nose was sunken.Conclusion The nasal cavity morphology of patients with nasal cavity deformity secondary to cleft lip and palate is obviously different from that of healthy people.The spiral CT three-dimensional reconstruction technology can effectively display the structure of the nasal passage,visually observe the position and direction of the nasal passage,and provide reliable data support for clinical plastic repair surgery.Clinical application value.