慢性鼻及鼻竇炎患者之鼻咽－帆咽界面

The Nasopharygo-velopharyngeal Interface of Patients with Chronic Rhinosinusitis

陳建志(Jiann-Jy Chen) ； 沈里國(Li-Kuo Shen) ； 王興萬(Hsing-Won Wang) ； 湯耀貿(Yao-Mao Tang) ； 陳登郎(Dem-Lion Chen)

《台灣耳鼻喉頭頸外科雜誌》 48卷1期 (2013/03) Pp. 7-12

https://doi.org/10.6286/2013.48.1.7

摘要

背景：運用電腦斷層之2維多層面數位重建可以對恰巧位於鼻咽－帆咽界面進行定性與定量的研究，可進一步採討慢性鼻及鼻竇炎患者之該界面狀況，以彌補傳統的反射鏡檢或內視鏡檢封該軸狀切面研究之不足。方法：共有207名（男127，女80）成年患者納入本研究，年齡48.5±15.8歲（平均值±標準差），均因慢性鼻及鼻竇炎曾於本院接受鼻竇電腦斷層檢查，兩側Lund-Mackay計分總分為8.2±6.2分。把儲存的主體像素輸出到後置影像處理系統，開啟2維多層面數位重建功能，找到該界面切面，測量該界面之面積與中軸前後徑。所有統計分析之α值為.05。結果：男性患者之該界面面積（48.1±16.2 mm^2）與女性患者（49.2±15.0 mm^2）相較並無差異（雙尾t檢定，p=.6355），與兩側Lund-Mackay計分總分間呈現有意義之負相關（r=-.211）與負向迴歸（b=-5.316）。男性患者之該界面中軸前後徑（18.6±4.6mm）與女性患者（19.5±4.0mm）相較亦無差異（雙尾t檢定，p=.1303），亦與兩側Lund-Mackay計分總分間呈現有意義之負相關（r=-.192）與負向迴歸（b=-.138）。然而，女性患者之該界面之中軸前後徑或面積，與其兩側Lund-Mackay計分總分間並無有意義之相關與迴歸。結論：本文首次確認在一般呼吸狀態下，仰臥姿勢時，慢性鼻及鼻竇炎之成年男性患者，其鼻咽－帆咽界面之中軸前後徑與面積均會隨兩側Lund-Mackay計分總分增加而減少，然而，缺乏正常對照組是本文研究上的限制。

關鍵字

鼻咽 ； 帆咽 ； 咽部氣道 ； 慢性鼻及鼻竇炎 ； Lund-Mackay計分

並列摘要

BACKGROUND: It is available to qualitatively and quantitatively study the nasopharygovelopharyngeal interface by computed-tomography 2D Multi-planar reformatting (MPR) rather than traditional mirror examination or indirect endoscope. This study elucidates the nasopharygo-velopharyngeal interface of patients with chronic rhinosinusitis.METHODS: 207 adult patients (127 men and 80 women) aged 48.5 ± 15.8 (average ± SD) were enrolled. They have received sinonasal computed tomography due to chronic rhinosinusitis. Bilateral total Lund-Mackay scoring (LMS) were 8.2 ± 6.2. The image data are transferred to a post-processing computer workstation that allows generation of 2D MPR. We generate the axial cut just at the nasopharygo-velopharyngeal interface. The area and midline anterior-posterior diameter are measured. The α value of all statistical analysis is .05.RESULTS: The interface area of men (48.1 ± 16.2 mm^2) is not different from that of women (49.2 ± 15.0 mm^2) (two-tailed t test, p = .6355), and is negatively correlated (r = -.211) and regressive (b = -5.316) with the bilateral total LMS. The interface midline anterior-posterior diameter of men (18.6 ± 4.6 mm) is not different from that of women (19.5 ± 4.0 mm)(two-tailed t test, p = . 1303), and is also negatively correlated (r = -.192) and regressive (b = -.138) with the bilateral total LMS. However, either the midline anterior-posterior diameter or area is not significantly correlated or regressive with women's bilateral total LMS.CONCLUSIONS: We performed a preliminary study to confirm the midline anteriorposterior diameter and area of the nasopharygo-velopharyngeal interface would decrease as the bilateral total LMS increases in men with chronic rhinosinusitis during tidal respiration on supine position. However, deficiency of normal control group is the limitation.

並列關鍵字

nasopharynx ； velopharynx ； pharyngeal airway ； chronic rhinosinusitis ； Lund-Mackay scoring