CAJ | 학술논문

目的探讨一种根据鼻窦影像学特点对钩突水平段进行分型的新方法.方法在鼻窦高分辨率CT冠状位扫描的钩突水平段层面,以下鼻道穹窿顶和眶底各作一条垂直线和水平线,以此参考线根据钩突主体位于十字架的象限区域,将其分为内下型、内上型,外上型及外下型4种类型.临床选取119例慢性鼻-鼻窦炎(chronic rhinosinusitis,CRS)患者术前进行钩突分型,在功能性内镜鼻窦手术中进行临床观察和验证,评估其对手术的指导意义.结果 119例CRS患者(238侧钩突)术前根据钩突分型方法进行了影像学分型,结果发现内下型钩突157侧,占66.0％;内上型40侧,占16.8％;外下型33侧,占13.9％;外上型8侧占3.3％.根据分型制定手术计划,119例患者在功能性内镜鼻窦手术中均找到上颌窦自然开口,发生眶纸板损伤2例,其中内上型1例,外上型1例.结论术前据此分型方法对钩突水平段进行影像学分型后在其指导下进行功能性内镜鼻窦手术,对于预判手术难度及预防眶并发症有一定指导意义.
목적 탐토일충근거비두영상학특점대구돌수평단진행분형적신방법.방법 재비두고분변솔CT관상위소묘적구돌수평단층면,이하비도궁륭정화광저각작일조수직선화수평선,이차삼고선근거구돌주체위우십자가적상한구역,장기분위내하형、내상형,외상형급외하형4충류형.림상선취119례만성비-비두염(chronic rhinosinusitis,CRS)환자술전진행구돌분형,재공능성내경비두수술중진행림상관찰화험증,평고기대수술적지도의의.결과 119례CRS환자(238측구돌)술전근거구돌분형방법진행료영상학분형,결과발현내하형구돌157측,점66.0％;내상형40측,점16.8％;외하형33측,점13.9％;외상형8측점3.3％.근거분형제정수술계화,119례환자재공능성내경비두수술중균조도상합두자연개구,발생광지판손상2례,기중내상형1례,외상형1례.결론 술전거차분형방법대구돌수평단진행영상학분형후재기지도하진행공능성내경비두수술,대우예판수술난도급예방광병발증유일정지도의의.
Objective To explore a new method for horizontal segment of uncinate process classification from image of nasal sinus.Methods On the level of horizontal segment of uncinate process of nasal sinus high resolution CT (HRCT) coronal scan.A vertical line and a parallel line were drawn started from the fornix top of the inferior meatus and orbital floor.The uncinate process which suited in the ‘ Cross’ regional was divided into four types by these lines.These were:intra-superior,intra-inferior and extrasuperior,extra-inferior.According to this method,119 patients with chronic sinusitis which were divided into these four types by the imaging classification for horizontal segment of uncinate process operated by functional endoscopic sinus surgery,and the treatment effects and the postoperative complications were analyzed.Results These 119 chronic sinusitis patients (238 sides uncinated process) were divided into four types by the imaging classification for uncinated process.The amount of intra-superior types was 66.0％ (157/238),the amount of intra-inferior types was 16.8％ (40/238),the amount of extra-superior types was 13.9％ (33/238),and the amount of extra-inferior types was 3.4％ (8/238).Functional endoscopic sinus surgery was performed according to this classification.All maxillary sinus natural ostium were found.Two cases occured orbital board damage (one was intra-superior,the other was extra-inferior).Conclusion The imaging classification for horizontal segment of uncinate process demonstrates a guiding significance for us to predict the difficulty of the operation and prevent the complications.