嗅裂区呼吸道上皮腺瘤样错构瘤与鼻息肉患者临床表现及鼻窦CT特征的对比分析研究

Comparative analysis of the clinical manifestations and sinus CT imaging features of respiratory epithelial adenomatoid hamartoma and nasal polyps in the olfactory cleft

目的比较病变位于双侧嗅裂区的呼吸道上皮腺瘤样错构瘤(respiratory epithelial adenomatoid hamartoma,REAH)与鼻息肉(nasalpolyps,NP)患者的临床和影像学特征,为二者的鉴别诊断提供证据。方法纳入2006年6月~2023年8月于北京同仁医院行鼻内镜手术治疗且病理证实为双侧嗅裂区REAH的患者,设为REAH组;纳入2023年1~10月于北京同仁医院行鼻内镜手术治疗且病理证实为双侧嗅裂区NP的患者,设为NP组。对两组患者的人口学特征、临床特征和影像学资料进行比较分析。结果研究纳入REAH组和NP组患者各155例。REAH组以老年男性居多,合并哮喘的患病率低于NP组(P<0.05)。鼻窦CT测量结果显示REAH组的双侧中鼻甲头端距离、双侧上鼻甲头端距离、中鼻甲与鼻中隔最大角度均大于NP组(P<0.05)。结论鼻窦CT有助于术前鉴别REAH并制定相应的治疗方案。

OBJECTIVE To analyze the differences in clinical and imaging characteristics of patients with respiratory epithelial adenomatoid hamatoma(REAH)and nasal polyps(NP)whose lesions are located in bilateral olfactory cleft regions,so as to provide evidence for clinicians in the preoperative differential diagnosis of REAH and NP.METHODS Patients with bilateral olfactory cleft REAH,who underwent nasal endoscopic surgery from June 2006 to August 2023 in Beijing Tongren Hospital,were retrospectively analyzed as the REAH group.Patients with bilateral olfactory cleft NP who underwent nasal endoscopic surgery from January 2023 to October 2023 in Beijing Tongren Hospital were included and set as the NP group.The demographic and clinical characteristics,as well as the sinus CT data were analyzed to explore the intergroup differences.RESULTS Both the REAH group and the NP group included 155 patients.The REAH group was dominated by older men,and the prevalence of comorbid asthma was lower than that in the NP group(P<0.05).In the REAH group,the middle turbinate width,the superior turbinate width,the ratio of middle turbinate width/orbital board width,the ratio of superior turbinate width/middle orbital board width,and the maximum angle between the middle turbinate and nasal septum were significantly higher than those in the NP group(P<0.05).CONCLUSION Sinus CT examination can help clinicians identify REAH lesions before surgery,which is conducive to the formulation and implementation of treatment plans.