额窦口参数及鼻丘气房形态学与慢性额窦炎病情严重程度的关系

The relationships between parameters of frontal ostium and morphological parameters of the agger nasi cell and the severity of chronic frontal sinusitis

目的探讨额窦口参数及鼻丘气房形态学与慢性额窦炎病情严重程度的关系。方法回顾性分析因其他疾病就诊而鼻窦正常患者25例及慢性额窦炎患者113例,根据软组织密度率(STDR)将研究对象分为0、1、2、3、4分组,应用鼻窦CT数据进行额窦及鼻丘气房三维重建并测量相关参数。采用Kruskal-wallis检验分析额窦口参数及鼻丘气房形态学与慢性额窦炎病情严重程度的关系。结果①额窦浑浊程度不同的5组患者的鼻丘气房形态学参数不完全相同。0分组的鼻丘气房体积、表面积、上下径均低于其他各组,差异具有统计学意义(P<0.05);0分组的鼻丘气房的左右径低于1分组和3分组,差异具有统计学意义(P<0.05);②额窦浑浊程度不同的5组患者的额窦口参数不完全相同。正常0分组额峡部前后径高于其他各组,0分组FI截面积高于2组、3分组和4分组,差异具有统计学意义(P<0.05);1分组FI值、FI截面积均高于3分组及4分组,差异具有统计学意(P<0.05),2分组FI截面积中位数高于4分组,差异具有统计学意义(P<0.05);与正常0分组相比,额窦浑浊程度越高,FI及FI截面积越小;③Spearman秩相关分析提示:FI截面积与FI值、额隐窝的前后径呈正相关(r_(s)=0.606,r_(s)=0.213,P<0.05),与鼻丘气房体积、表面积及上下径呈弱的负相关(r_(s)=-0.154,r_(s)=-0.161,r_(s)=-0.250,P<0.05),鼻丘气房体积与FI呈弱的负相关(r_(s)=-0.276,P<0.05)。结论鼻丘气房形态学参数和FI值、FI截面积参与慢性额窦炎的发生、发展,且FI值、FI截面积与疾病的严重程度呈负相关。

Objective To investigate the relationships between parameters of frontal ostium and morphological parameters of agger nasi cell and the severity of chronic frontal sinusitis(CFS).Methods Retrospective analysis was performed to 25 patients with normal sinuses(control group)and 113 CFS patients(CFS group).According to the soft tissue density rate(STDR,%),all the subjects in both groups were subdivided into subgroups of 0,1,2,3 and 4 points.Their computerized tomography data were used for three-dimensional reconstruction of frontal sinus and agger nasi cell,and relevant parameters were measured.The Kruskal-wallis test was used to analyze the relationships between parameters of frontal ostium and morphological parameters of agger nasi cell and the severity of CFS.Results①Morphological parameters of the agger nasi cell were not identical in the five groups of patients with different degrees of frontal sinus turbidity.The volume,surface area,and vertical diameter of the agger nasi cell of group 0 were lower than those of the other groups,and the differences were statistically significant(P<0.05);the mediolateral dimension of the agger nasi cell of group 0 were lower than those of groups 1 and 3,and the differences were statistically significant(P<0.05).②The parameters of frontal ostium were not identical in the five groups of patients with different degrees of frontal sinus turbidity.The anterior-to-posterior(A-P)length of the isthmus of normal group 0 was higher than the rest of the groups,and the FI cross-sectional area of group 0 was higher than that of groups 2,3 and 4,with statistically significant differences(P<0.05).The FI value and FI cross-sectional area of group 1 were higher than those of groups 3 and 4,with statistically significant differences(P<0.05),and the FI cross-sectional area of group 2 was higher than that of group 4,with statistically significant differences(P<0.05).The higher the degree of frontal sinus turbidity,the smaller the FI and FI cross-sectional area compared with the normal 0 group.③Spearman rank correlation analysis suggests that:FI cross-sectional area was positively correlated with FI and FR values(r_(s)=0.606,r_(s)=0.213,P<0.05)and weakly negatively correlated with the volume,surface area and vertical diameter of the nasal nasi cell(r_(s)=-0.154,r_(s)=-0.161,r_(s)=-0.250,P<0.05).The volume of the nasal nasi cell was weakly negatively correlated with FI(r_(s)=-0.276,P<0.05).Conclusion Morphological parameters of the agger nasi cell and FI value and FI cross-sectional area are involved in the occurrence and development of CFS,and are negatively correlated with the severity of CFS.