- 期刊
國人篩骨雞冠氣室化及鼻竇炎額竇感染關係之研究
The Crista Galli Pneumatization and Its Relationship to Frontal Sinusitis in Taiwan
摘要
鼻竇炎是國人常見的呼吸道疾病，鼻竇炎早期臨床症狀：鼻塞、鼻涕倒流、頭痛。經年累月慢性鼻竇炎持續惡化結果更可引起嚴重的併發症如：眼眶蜂窩性組織炎、腦膜炎、硬腦膜外膿瘍、乙狀竇栓塞……等。感染的範圍廣泛，包含額竇、蝶竇以及上額竇。在解剖位置上，篩骨雞冠(crista galli C.G.)解剖位置位介於額竇和篩竇之間。因為它的位置特殊，若能得知篩骨雞冠的發育途徑，或可了解治療慢性鼻竇炎的感染途徑。們收集2007年11月到2008年6月至本院做頭部（包含腦部、眼眶、鼻竇）電腦斷層檢查的個案共432名做分析。結果發現，13歲以上個案篩骨雞冠有氣室化的比例約為42.68%，且他們均有發育良好的額竇，顯示篩骨雞冠的氣室化時間和額竇發育時間一樣較晚。由此印證P.M. Som在AJNR 2009年所發表的論文推論篩骨雞冠氣室化是由左邊或右邊額竇延續發育而成的合理性。我們還發現，慢性鼻竇炎的病人，當雞冠有氣室化且發炎時，同時額竇發炎的比率亦升高，此結論可提供耳鼻喉科醫生在診斷及治療慢性鼻竇炎時做為參考。
並列摘要
Sinusitis is a respiratory disease commonly seen in Taiwan. Early signs of sinusitis includes: nasal congestion, post-nasal drip and headaches. Chronic sinusitis can result in serious sequelae such as orbital cellulites, meningitis, and subdural abscesses, etc. Infection can spread to a wide variety of locations, including frontal, ethmoid, sphenoid, and maxillary sinuses. Anatomically, the crista galli (CG) is located in between the fronal and ethmoid sinuses. Because of its unique location, we propose that the study of CG development may yield insight to the route of infection in chronic sinusitis, which will in turn aid in diagnosis and treatment of this common disease We therefore initiated a review of whole brain CT scans (including brain, orbital and sinus regions) conducted in our hospital. We studied 432 cases from November of 2007 to June of 2008, analyzing the percentage of CG pneumatization and the path of CG development in order to learn how it is associated with chronic frontal sinusitis. The result revealed that the proportion of C.G. pneumatization in all cases above 13 years old is about 42.68%. A11 cases with C.G pneumatization also show good pneumatization of frontal sinuses. So we think that the development of C.G. is as late as frontal sinuses among the development of all paranasal sinuses. This result is compatible with the conclusion of P.M Son who thought C.G. is developed from frontal sinus instead of ethmoid sinus. We also find that the cases of paranasal sinusitis involving pneumatized C.G. have higher incidence involving frontal sinuses. This conclusion may provide otolaryngologist some help in diagnosis and treatment of chronic paranasal sinusitis.