鼻中隔偏曲与慢性鼻-鼻窦炎、窦口鼻道复合体解剖变异的关系

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Abstract Objective To investigate the relationship between deviation of nasal septum, chronic rhinosinusitis (CRS) and anatomical variation of ostiomeatal complex (OMC). Methods Retrospective analysis was performed on 200 patients with deviation of nasal septum diagnosed in the First Affiliated Hospital of Xinxiang Medical University from December 2017 to July 2019. According to the absence of sinusitis, they were divided into CRS group (122 cases) and non-CRS group (78 cases). Combined with the CT imaging findings of the sinuses, the deviation of nasal septum, OMC anatomical variation and the incidence of sinusitis in the two groups were analyzed. Results The proportion of high deviation and severe deviation of nasal septum in CRS group was higher than that in non-CRS group, and the difference was statistically significant (P ＜ 0.05). The CT score distribution of Lund-Mackay sinus in the narrow nasal cavity of the maxillary sinus, anterior ethmoid sinus, posterior ethmoid sinus and frontal sinus in the CRS group was different from that of the broad nasal cavity (P ＜ 0.05). The CT score distribution of Lund-Mackay sinus in the narrow nasal cavity of the sphenoid sinus was no statistically significant different from that of the broad nasal cavity (P ＞ 0.05). Anterior ethmoid sinusitis and frontal sinusitis in the CRS group had statistically significant differences in the high and low deviation of the nasal septum (P ＜ 0.05). Differences in the variation rates of middle turbinate hypertrophy, ethmoid hypertrophy, uncinate hypertrophy, middle turbinate reverse tension, vesicular middle turbinate and middle turbinate compression under compression on both sides of nasal cavity in non-CRS group were statistically significant (P ＜ 0.05 or P ＜ 0.01). There were no significant differences between Haller, Onodi and Agger air chamber in bilateral nasal cavity (P ＞ 0.05). The variation rates of middle turbinate hypertrophy, ethmoid hypertrophy, middle turbinate antitension, vesicular middle turbinate and Agger gas chamber in the non-CRS group were higher than those in the low turbinate, and the differences were statistically significant (all P ＜ 0.05). However, in the non-CRS group, there were no statistically significant differences in the variation rates of uncinate hypertrophy, middle turbinate compression, Haller and Onodi air chamber when the nasal septum was high and low deviated (P ＞ 0.05). Conclusion The constituent ratio of CRS is higher when the nasal septum is high deviated and severe deviated, and the severity of sinusitis is different on the broad and narrow side. The incidence of OMC variation in different nasal cavity and different deviated position is different, which may be caused by compensatory development abnormality of OMC structure after nasal cavity broadening, which may cause obstructive changes of ipsilateral sinuses.

Key words： Deviation of nasal septum Ostiomeatal complex Multi-slice helicai CT Chronic rhinosinusitis

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	REN Panpan YU Wenfa

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REN Panpan YU Wenfa. Relationship between deviation of nasal septum, chronic rhinosinusitis and anatomical variation of ostiomeatal complex[J]. 中国医药导报, 2020, 17(18): 123-126.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2020/V17/I18/123

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