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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

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。

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.