CT扫描分析窦口鼻道复合体解剖变异在鼻窦炎发病中的意义

目的探讨窦口鼻道复合体（ｏｓｔｉｏｍｅａｔａｌｃｏｍｐｌｅｘ，ＯＭＣ）解剖变异与慢性鼻窦炎的关系，分析其在内窥镜鼻窦手术中的重要性。方法以２９７例（５９４侧）冠状位鼻窦ＣＴ片为材料研究中鼻甲、钩突、筛泡和鼻丘的解剖变异及Ｈａｌｅｒ气房的影像特点，结合病史分析解剖变异与慢性鼻窦炎的关系，用ＳＰＳＳ５．０作统计分析。结果ＯＭＣ解剖变异包括中鼻甲反向弯曲（１３．９７％）、气化（３４．８５％），钩突肥大（１９．３６％）、偏移（４５．２７％），筛泡过度气化（３０．３０％），鼻丘过度气化（０．７０％），Ｈａｌｅｒ气房（１．００％）。ＯＭＣ解剖变异总出现率为８１．１４％；钩突、中鼻甲和筛泡的变异与慢性鼻窦炎的发病呈正相关（Ｐ＜０．０１）。结论ＯＭＣ解剖变异常见，且与慢性鼻窦炎密切相关，处理ＯＭＣ解剖变异是内窥镜鼻窦手术的一项重要内容。

Anatomic variations of the ostiomeatal complex and their correlation with chronic sinusitis: CT evaluation

Objective To explore the relationship between anatomic variations in the ostiomeatal complex(OMC) and chronic sinusitis. MethodsBZCoronal plane CT scans of the paranasal sinuses showing the ostiomeatal complex including the middle turbinate, uncinate, ethmoid bulla, agger nasi and Haller cell were analyzed in 297 individuals (594 sides). Statistical analyses were carried out with SPSS 5.0. Results There were 81.14% of OMC noted to have at least one variation. The anatomic variations included paradoxical curvature of the middle turbinate (13.97%), the pneumatized middle turbinate (34.85%), uncinate hyperplasia(19.36%), deviation of uncinate (45.27%),large ethmoidal bulla (30.30%), large agger nasi (0.70%) and Haller cell (1.00%). The correlation between variations and chronic sinusitis was significant (P<0.01). Conclusion The occurrence of OMC variation is common. The variations may be one of the causes of chronic sinusitis. Therefore, properly handling the variations was important in the endoscopic sinus surgery.