鼻中隔偏曲两侧窦口鼻道复合体解剖变异的差异

目的探讨鼻中隔偏曲患者两侧窦口鼻道复合体（ostiomeatalcomplex,OMC）的解剖变异。方法对103例不同部位鼻中隔偏曲的患者作鼻内窥镜检查和鼻窦冠状位、轴位CT扫描，比较两侧OMC解剖变异发生率和鼻窦炎发病率的差异。结果偏曲对侧中、下鼻甲肥大的发生率明显高于同侧（P<0.05），筛泡和鼻丘气房的宽度也明显大于同侧（配对t检验，P<0.01）；中鼻甲反常曲线偏曲同侧的发生率明显高于对侧（配对t检验，P<0.01），其它解剖变异偏曲两侧差异无显著性。偏曲两侧鼻窦炎的发病率差异无显著性(P>0.05)。结论鼻中隔偏曲可能引起偏曲对侧中鼻甲及鼻腔外侧壁结构的代偿性改变，这种改变可能在偏曲对侧鼻窦炎的发病中起着一定的作用。

Differences of anatomic variations in ostiomeatal complex between two sides of the deviated septum

Objective To explore the influence of the deviated septum on the development of ostiomeatal complex (OMC). Methods Nasal endoscopic examination and CT scan of the paranasal sinuses of 103 patients with nasal septal deviation were analyzed. The differences of anatomic variations in OMC between ipsilateral and contralateral sides in relation to the direction of septal deviation. The incidence of sinusitis on either side of the deviated septum was evaluated. Results On the side opposite to the deviated septum, the incidence of middle and inferior turbinate hypertrophy was higher than that of the deviated side( P < 0.05). The width of agger nasi and ethmoid bulla was on the contralateral side larger than that of the ipsilateral side ( P < 0.01). The incidence of paradoxical curvature of middle turbinate on the ipsilateral side was higher than that of contralateral side ( P < 0.01). Other anatomic variations showed no significant differences between two sides of the deviated septum ( P > 0.05), nor was there any difference between the incidence of sinustis on the two sides. Conclusion Some compensatory changes in middle and inferior turbinates and lateral nasal wall on the opposite side to the deviation might be caused by the deviated septum.