鼻中隔偏曲对中鼻甲位置的影响及其临床意义

Influence of nasal septum deviation on the position of middle turbinate and its clinical significance

目的探讨鼻中隔偏曲(NSD)对患者中鼻甲(MT)位置的影响及其对鼻中隔成形术的临床意义。方法对2018年2月—2019年12月因NSD行鼻中隔成形术联合MT手术的100例患者的鼻窦CT进行回顾性分析。利用GE医疗图像系统(Centricity Enterprise Web 3)测量NSD的偏曲程度和鼻腔凹、凸侧MT的结构指标,分析MT结构指标与NSD的偏曲程度之间的关系。结果鼻腔凸侧MT宽度(4.56±1.55)mm显著小于凹侧(7.01±1.75)mm(P<0.01),凸侧MT内侧缘距离中线的距离(5.04±1.37)mm显著大于凹侧(1.48±1.50)mm(P<0.01)。MT宽度与NSD的偏曲程度在凹侧呈正相关(r=0.245;P<0.05),在凸侧呈负相关(r=-0.420;P<0.01)。MT到中线的距离与NSD的偏曲程度在凹侧呈负相关(r=-0.430;P<0.01),在凸侧呈正相关(r=0.549;P<0.01)。结论NSD患者凹侧MT代偿性肥大并向中线移位,凸侧MT适应性缩小并远离中线。在鼻中隔成形术中,对包括泡状中鼻甲(CB)在内的肥大MT有必要给予更多关注。

Objective To investigate the impact of nasal septal deviation(NSD)on the position of middle turbinate(MT)and its clinical.Methods Imaging data of paranasal sinus computed tomography(CT)in 100 patients with NSD underwent septoplasty combined with turbinate surgery from Feb 2018 to Dec 2019 were investigated retrospectively.GE Medical Image System(Centricity Enterprise Web 3)was adopted to measure the degree of NSD and the concave and convex structure parameters of MT.The correlation between MT index and the degree of NSD was analyzed.Results The width of MT on the convex side(4.56±1.55)mm was smaller than that on the concave side(7.01±1.75)mm(P<0.01).The distance between the MT and the midline on the convex side(5.04±1.37)mm was significantly larger than that on the concave side(1.48±1.50)mm(P<0.01).The NSD degree showed a positive correlation with the width of MT on the concave side(r=0.245,P<0.05)and a negative correlation on the convex side(r=-0.420,P<0.01).The correlation of the NSD degree with distance between MT and the midline was negative on the concave side(r=-0.430,P<0.01)and positive on the convex side(r=0.549,P<0.01).Conclusions In patients with NSD,there are MT compensatory hypertrophy in concave side and shift to the midline,and the adaptability of MT on convex side is reduced and away from the midline.The hypertrophic MT including concha bullosa should be paid attention to in septoplasty.