慢性鼻竇炎患者之鼻鼻竇腔解剖變異

Anatomical Variations of the Nasosinal Cavities in Patients with Chronic Paranasal Sinusitits

楊偉杰(Wei-Jay Yang) ； 郝治華(Justin Jyh-Hwa Hao) ； 廖兆旺(Chao-Wan Liao)

《中華民國耳鼻喉科醫學雜誌》 36卷3期 (2001/03) Pp. 165-171

https://doi.org/10.6286/2001.36.3.165

摘要

背景：慢性鼻竇炎為耳鼻喉科常見之疾病，現階段對其病理生理學的了解主要是由於解剖上鼻竇開口黏膜病變引發阻塞，因此對於考慮接受手術之病人，電腦斷層掃瞄對鼻竇解剖之了解相當重要。本研究希望透過一個系統性的表格來判讀電腦斷層影像，以提供周詳的診斷和治療資料。
方法：從2000年1月到9月，在本院診斷為慢性鼻竇炎且接受電腦斷層掃瞄之成人病患，以一系統化的表格來記錄其電腦斷層影像之發現，表格上記錄病人的基本資料，及Lund及Kennedy所提出的radiologic staging system將鼻竇黏膜病變之量化分數，及解剖變異，並將它標示在一冠狀切圖上，然後加以統計其解剖變異。
結果：共收集103名慢性鼻竇炎患者之電腦斷層影像學檢查。其中，男性為57名，女性為46名。平均年齡為43歲。依據Lund及Kennedy所提出的radiologic staging system，病人平均分數為11.3分，而解剖變異以agger nasi cells出現比率最高共96名（93.2%），其次鼻中隔彎曲53名（51.5%），Haller cells 23名（22.3%）。
結論：電腦斷層影像學檢查被認為是了解鼻竇構造的重要檢查工具。尤其，可以提供鼻竇精細骨骼變異及了解鼻竇炎侵犯鼻竇各部分的程度。透過系統化表格對電腦斷層影像的回顧，使我們對鼻竇炎患者的病情有精準的評估，並提醒手術者特別注意其可能變異，進而掌握鼻竇手術之精髓。

關鍵字

解剖變異 ； 電腦斷層掃瞄 ； 鼻竇炎

並列摘要

BACKGROUND: Chronic paranasal sinusitis is one of the most frequently encountered complaints in ENT clinics. The pathophysiology of chronic paranasal sinusitis is now understood to be the results of mucosal injury induced by congestion over the sinus ostium. Understanding the anatomy of the sinuses with CT scans is important for patients who fail to respond to medical treatment, suffer from periodic recurrence, or are contemplating surgery. To aid interpretation of CT imaging, this study analyzed CT findings with a systematic chart.
METHODS: Between January and September 2000, adult patients in our hospital who had been diagnosed with chronic paranasal sinusitis and had received CT scans were enrolled. CT imaging findings were analyzed with a systematic chart. The chart recorded patients' backgrounds, recorded sinus involvement using Lund and Kennedy's radiologic staging system, recorded anatomical variations on coronal section diagrams, with the information collected then undergoing statistical analysis.
RESULTS: There were a total of 103 cases of chronic paranasal sinusitis confirmed by CT scans. Of the cases, 57 were male and 46 were female. The average age was 43. Using Lund and Kennedy's radiologic staging system, the average score was 110.3 points for the cases. Anatomical variants included 96 cases with agger nasi cells (93.2%), 53 with a deviated nasal septum (51.5%), and 23 with Haller cells (22.3%).
CONCLUSIONS: The CT scan is crucial to assessment of sinus structure. It not only provides fine sinus bone details, but also helps to identify the parts of the sinus affected by sinusitis. Systematic re-examination of CT images enables the condition of sinuses in patients with sinusitis to be assessed, and allows doctors to identify variations relevant to operations for sinusitis.

並列關鍵字

anatomic variation ； computerized tomography ； sinusitis