CAJ | 학술논문

目的：应用多螺旋CT检测窦口-鼻道复合体（ OMC）解剖变异发生率及探讨其与慢性鼻窦炎发生的关系。方法回顾性分析本院933例健康查体者鼻窦扫描图像，薄层横断图像重建冠状面图像，观察OMC解剖变异情况：中鼻甲（反曲、气化）、筛泡过度气化、钩突（偏曲、肥大、气化）、鼻丘过度气化、Haller气房，并比较解剖变异发生差异。结果933例查体者中慢性鼻窦炎发生率为30．1％，发生率最高为慢性上颌窦炎，在OMC变异中，中鼻甲反曲、气化、筛泡过度气化、钩突偏曲、肥大、气化、鼻丘过度气化、Haller 气房发生率为分别为1．7％、13．8％、5．8％、6．8％、5．1％、1．1％、0．4％、2．7％。 OMC变异分别在慢性上颌窦、筛窦炎及额窦炎的发生差异均有显著性（P＜0．01）。混合变异组鼻窦炎发生率明显高于单一变异组。在剔除吸烟因素的457例非吸烟者中，OMC变异与慢性上颌窦、筛窦炎、额窦炎的发生差异有显著性（ P＜0．05）。单一变异因素中，中鼻甲偏曲、钩突气化、钩突偏曲、钩突肥大与慢性上颌窦炎发生关系密切；筛泡过度气化与慢性筛窦炎关系密切；钩突偏曲与慢性额窦炎关系密切。结论（1）多螺旋CT能清楚地显示OMC的解剖变异，在鼻窦炎患者病因探究及手术治疗方案制定前螺旋CT扫描具有明显的临床意义，应作为鼻窦炎常规的检查手段。（2） OMC单一变异和混合变异均与慢性上颌窦、筛窦炎的发生具有相关性，各种变异在慢性鼻窦炎发生中作用不一致。
목적：응용다라선CT검측두구-비도복합체（ OMC）해부변이발생솔급탐토기여만성비두염발생적관계。방법회고성분석본원933례건강사체자비두소묘도상，박층횡단도상중건관상면도상，관찰OMC해부변이정황：중비갑（반곡、기화）、사포과도기화、구돌（편곡、비대、기화）、비구과도기화、Haller기방，병비교해부변이발생차이。결과933례사체자중만성비두염발생솔위30．1％，발생솔최고위만성상합두염，재OMC변이중，중비갑반곡、기화、사포과도기화、구돌편곡、비대、기화、비구과도기화、Haller 기방발생솔위분별위1．7％、13．8％、5．8％、6．8％、5．1％、1．1％、0．4％、2．7％。 OMC변이분별재만성상합두、사두염급액두염적발생차이균유현저성（P＜0．01）。혼합변이조비두염발생솔명현고우단일변이조。재척제흡연인소적457례비흡연자중，OMC변이여만성상합두、사두염、액두염적발생차이유현저성（ P＜0．05）。단일변이인소중，중비갑편곡、구돌기화、구돌편곡、구돌비대여만성상합두염발생관계밀절；사포과도기화여만성사두염관계밀절；구돌편곡여만성액두염관계밀절。결론（1）다라선CT능청초지현시OMC적해부변이，재비두염환자병인탐구급수술치료방안제정전라선CT소묘구유명현적림상의의，응작위비두염상규적검사수단。（2） OMC단일변이화혼합변이균여만성상합두、사두염적발생구유상관성，각충변이재만성비두염발생중작용불일치。
Objective To study the incidence of anomaly of ostiomeatal complex ( OMC) and its relation to chronic sinusi-tis.Methods CT images of 933 cases who received health examination were retrospectively analyzed .The anatomical variants of OMC were clearly displayed by MPR .Variants of middle turbinate recurvation/gasification , ethmoidal bulla excessive gasi-fication,uncinate process diviation/hypertrophy/gasification,agger excessive gasification,and Haller cell were observed and compared in order to search the relation between anomaly and sinusitis .Results In the 933 cases,the incidence of chronic si-nusitis was 30.12%,with chronic genyantritis being the highest .The incidences of OMC anomaly were 1.7%,13.8%,5.8%, 6.8%,5.1%,1.1%,0.4%,and 2.7%respectively.OMC anomaly in chronic genyantritis ,ethmoidal sinusitis and frontal si-nusitis showed significant differences (P<0.01).The incidence of nasosinusitis in the mixed anomaly group was remarkably higher than the single anomaly group .In 457 cases of non-smokers,OMC anomaly was significantly related to the incidence differences of chronic genyantritis ,ethmoidal sinusitis and frontal sinusitis (P<0.05).In terms of single anomaly factors,mid-dle turbinate recurvation ,uncinate process gasification/diviation/hypertrophy were closely related to the incidence of chronic genyantritis;ethmoidal bulla excessive gasification was closely related to chronic ethmoidal sinusitis ;uncinate process diviation was closely related to chronic frontal sinusitis .Conclusion 1.Multi-slice CT can clearly show the anomaly of OMC .2.Differ-ent anomalies of OMC play different roles in the development of chronic sinusitis .