Background Intersinus septal cell （ISSC） is not a very uncommon frontal recess cell. But it is poorly described in literature. The clinical significance of this anatomic variant still remains unclear. The purpose of...Background Intersinus septal cell （ISSC） is not a very uncommon frontal recess cell. But it is poorly described in literature. The clinical significance of this anatomic variant still remains unclear. The purpose of this study was to clarify the anatomy, classification of ISSC and its clinical significance in Chinese subjects. Methods We prospectively identified ISSC in 200 consecutive subjects who had undergone computed tomography （CT） scans： 120 without frontal sinusitis （group 1 ） and 80 with frontal sinusitis （group 2）. The ISSC was classified into two types： Type ⅠISSC communicated with frontal sinuses, type Ⅱ ISSC communicated with frontal recess. The patients of frontal sinusitis had undergone functional endoscopic sinus surgery with the assistance of the classification of ISSC. Statistical analysis was performed to correlate the ISSC and its type to the presence of frontal sinusitis. Results The ISSC was obvious when reviewing the coronal and axial CT scans. Of the 200 CT scans reviewed, ISSC were present in 90 （45%）. Of the 120 scans in group 1, ISSC were present in 49 （41%）, among which type ⅠISSC was in 22 （18%） and type Ⅱ was in 27 （23%）. Of the 80 scans in group 2, ISSC was present in 41 （51%）, among which type Ⅰ ISSC was in 16 （20%） and typeⅡwas in 25 （31%）. There were no statistically significant differences about the frequency distribution of total ISSC, type Ⅰ and Ⅱ ISSC between group 1 and group 2. Conclusions The prevalence of ISSC was very high in Chinese patients. The classification of ISSC was helpful for surgeon to operate according to whether it communicated with frontal sinus or frontal recess. The type Ⅱ ISSC could be relatively easily removed from frontal recess.展开更多
目的通过CT研究低位筛前动脉(low-lying anterior ethmoidal artery,LAEA)与周围结构的解剖影像学关系,明确其定位,避免术中损伤。方法回顾研究2018年5月~2021年5月于上海交通大学医学院附属第六人民医院确诊的126例慢性鼻窦炎(chronic ...目的通过CT研究低位筛前动脉(low-lying anterior ethmoidal artery,LAEA)与周围结构的解剖影像学关系,明确其定位,避免术中损伤。方法回顾研究2018年5月~2021年5月于上海交通大学医学院附属第六人民医院确诊的126例慢性鼻窦炎(chronic rhinosinusitis,CRS)患者,所有患者均行鼻窦CT检查,通过Horos软件重建,测量筛前动脉(anterior ethmoidal artery,AEA)与颅底的距离、额窦前壁到颅底水平部与垂直部相交点的最大水平距离(longest horizontal diameter from the anterior wall of the frontal sinus to the skull base at which point the slope turns vertical to horizontal,APF)、包含LAEA的骨板与颅底向前的夹角(forward angle between the lamella containing the low anterior ethmoid artery and the skull base,FALS),测量筛板外侧板(lateral lamella of the cribriform plate,LLCP)高度并按Keros分型分类,按国际额窦解剖分类方法(international frontal sinus anatomy classification,IFAC)定义患者气房类型。t检验、χ^(2)检验做差异性分析,Spearman、Pearson分析比较其相关性。结果在126例(252侧)患者中,有、无眶上筛房(supraorbital ethmoid cell,SOEC)及有、无筛泡上气房(supra bulla cell,SBC)患者的AEA低位走行率比较,差异均有统计学意义(χ^(2)=141.40,P<0.001;χ^(2)=138.05,P<0.001);KerosⅠ型、Ⅱ型、Ⅲ型与LAEA分别呈负相关(r=-0.592,P<0.001)、正相关(r=0.531,P<0.001)、正相关(r=0.172,P<0.001);LAEA与颅底之间的距离和APF之间呈正相关(r=0.25,P<0.001);当存在SOEC、SBC,KerosⅡ型、KerosⅢ型及更大的APF,AEA低位走行率明显升高。在FALS中,91.5%为锐角,7.8%为直角,0.7%为钝角。结论SOEC、SBC、高级别Keros分型、APF长度及FALS是术前定位LAEA的可靠标志。通过术前阅片,明确其解剖关系,对于内镜手术时减少AEA损伤有重要临床意义。展开更多
文摘Background Intersinus septal cell （ISSC） is not a very uncommon frontal recess cell. But it is poorly described in literature. The clinical significance of this anatomic variant still remains unclear. The purpose of this study was to clarify the anatomy, classification of ISSC and its clinical significance in Chinese subjects. Methods We prospectively identified ISSC in 200 consecutive subjects who had undergone computed tomography （CT） scans： 120 without frontal sinusitis （group 1 ） and 80 with frontal sinusitis （group 2）. The ISSC was classified into two types： Type ⅠISSC communicated with frontal sinuses, type Ⅱ ISSC communicated with frontal recess. The patients of frontal sinusitis had undergone functional endoscopic sinus surgery with the assistance of the classification of ISSC. Statistical analysis was performed to correlate the ISSC and its type to the presence of frontal sinusitis. Results The ISSC was obvious when reviewing the coronal and axial CT scans. Of the 200 CT scans reviewed, ISSC were present in 90 （45%）. Of the 120 scans in group 1, ISSC were present in 49 （41%）, among which type ⅠISSC was in 22 （18%） and type Ⅱ was in 27 （23%）. Of the 80 scans in group 2, ISSC was present in 41 （51%）, among which type Ⅰ ISSC was in 16 （20%） and typeⅡwas in 25 （31%）. There were no statistically significant differences about the frequency distribution of total ISSC, type Ⅰ and Ⅱ ISSC between group 1 and group 2. Conclusions The prevalence of ISSC was very high in Chinese patients. The classification of ISSC was helpful for surgeon to operate according to whether it communicated with frontal sinus or frontal recess. The type Ⅱ ISSC could be relatively easily removed from frontal recess.
文摘目的通过CT研究低位筛前动脉(low-lying anterior ethmoidal artery,LAEA)与周围结构的解剖影像学关系,明确其定位,避免术中损伤。方法回顾研究2018年5月~2021年5月于上海交通大学医学院附属第六人民医院确诊的126例慢性鼻窦炎(chronic rhinosinusitis,CRS)患者,所有患者均行鼻窦CT检查,通过Horos软件重建,测量筛前动脉(anterior ethmoidal artery,AEA)与颅底的距离、额窦前壁到颅底水平部与垂直部相交点的最大水平距离(longest horizontal diameter from the anterior wall of the frontal sinus to the skull base at which point the slope turns vertical to horizontal,APF)、包含LAEA的骨板与颅底向前的夹角(forward angle between the lamella containing the low anterior ethmoid artery and the skull base,FALS),测量筛板外侧板(lateral lamella of the cribriform plate,LLCP)高度并按Keros分型分类,按国际额窦解剖分类方法(international frontal sinus anatomy classification,IFAC)定义患者气房类型。t检验、χ^(2)检验做差异性分析,Spearman、Pearson分析比较其相关性。结果在126例(252侧)患者中,有、无眶上筛房(supraorbital ethmoid cell,SOEC)及有、无筛泡上气房(supra bulla cell,SBC)患者的AEA低位走行率比较,差异均有统计学意义(χ^(2)=141.40,P<0.001;χ^(2)=138.05,P<0.001);KerosⅠ型、Ⅱ型、Ⅲ型与LAEA分别呈负相关(r=-0.592,P<0.001)、正相关(r=0.531,P<0.001)、正相关(r=0.172,P<0.001);LAEA与颅底之间的距离和APF之间呈正相关(r=0.25,P<0.001);当存在SOEC、SBC,KerosⅡ型、KerosⅢ型及更大的APF,AEA低位走行率明显升高。在FALS中,91.5%为锐角,7.8%为直角,0.7%为钝角。结论SOEC、SBC、高级别Keros分型、APF长度及FALS是术前定位LAEA的可靠标志。通过术前阅片,明确其解剖关系,对于内镜手术时减少AEA损伤有重要临床意义。
