- 期刊
鼻竇鼻腔疾患之電腦斷層評估
CT Scan Evaluation of Sino-nasal Diseases
摘要
慢性鼻竇炎及慢性肥厚性鼻炎有許多共同的症狀，如果僅以臨床症狀或鼻竇X-光來做鑑別診斷極有可能誤診。因此在鼻竇手術之前以電腦斷層攝影來做診斷，不僅能減少誤診率，同時亦可提供精確手術範圍及修正手術方式。耕莘醫院民國81年1月至81年12月，共經驗350例疑似慢性鼻竇炎患者，以電腦斷層檢查之結果，發現鼻竇完全正常者有101例，佔28.86%，有鼻竇病變者249例，佔71.14%，鼻竇病變中以上頷竇219例（87.95%）為最多，其次依序為篩竇183例（73.49%），前額竇81例（32.53%），及蝶竇56例（22.49%）。按Sonkens等之分類法可發現：上頷竇漏斗型（infundibulum）有70側（16.87%），口道單元型(ostiomeatal unit)231側，佔55.66%，緤篩竇隱窩型（spheno-ethmoid recess）15側，佔3.61%，多發性鼻息肉型(sinonasal poly-posis)80側，佔19.28%，未能分類型（unclassified）19側，佔4.58%。利用鼻竇電腦斷層不僅能做病灶定位，同時能夠提供調整鼻竇內視鏡手術步驟之依據。
並列摘要
Chronic sinusitis and chronic hyper-trophic rhinitis share several common clini-cal symptoms, therefore, misdiagnosis may be the result of mere clinical approach without the assistance of sinus CT. Func-tional endoscopic sinus surgery has prevailed in the management of sinus disease recently, but it relies upon the sinus CT to provide the mapping of lesion sites, furthermore, the key areas to be removed in the surgical procedures. From January to December 1991, we experienced 350 consecutive patients with sino-nasal disease. With analysis of sinus CT scan, we found 101 cases (28.68%) in which all the sinuses were normal and the other 249 cases (73.49%), at least one sinus was involved in the sinus CT. The frequency of each sinus involve-ment was as follows: maxillary sinus, 219 cases (87.95%), then followed by ethmoid sinus, 183 cases (73.49%), frontal sinus, 81 cases (32.53%), and sphenoid sinus, 56 cases (22.49%). According to the clas-sification of Sonkens et al, tyoe 1 (infundibular type), 70 sides (16.87%), type 2 (osteomeatal unit), 231 sides (55.66%), type 3 (spheno-ethmoid recess), 15 sides (3.61%), type 4 (sinonasal polypo-sis), 80 sides (19.28%), type 5 (unclassi-fied), 19 sides (4.58%). With the applica-tion of sinus CT, we can not only map the sinus lesion but also tailor the endo-scopic sinus surgical procedures.