摘要
目的 基于CT的3D建模方法探讨下鼻甲缺失患者行下鼻道填充术(IMAP)手术前后鼻腔容积相关物理量的变化。方法 回顾性收集20例伴有特殊症状的下鼻甲继发性缺失(SITL)患者的空鼻症6项量表(ENS6Q)评分及CT影像,通过3D建模的方式估算鼻腔容积及鼻腔黏膜表面积,计算其鼻腔下部容积比,与ENS6Q评分进行相关性分析;通过SITL患者手术前后的CT影像计算鼻腔容积及鼻腔黏膜表面积,并进行对比分析,将接受IMAP患者术前估算鼻腔下部容积减去术中填充物体积计算推测鼻腔下部容积及容积比,并与20例无鼻窦疾病的对照组进行对比,据此尝试对术中填充物的体积给出建议。结果 SITL且伴有特殊症状患者在IMAP术后的ENS6Q总分显著下降,且均低于11分(P=0.003),但仍显著高于对照组。在容积方面,IMAP显著降低了SITL且伴有特殊症状患者的估算鼻腔下部分容积比(P=0.021),IMAP术后的SITL且伴有特殊症状患者与对照组无明显差异。在黏膜表面积方面,IMAP术后的SITL且伴有特殊症状患者的估算鼻腔下部分黏膜表面积显著降低(P=0.021),但其黏膜表面积大小与对照组比较具有显著差异,且该差异与术前差异相仿。估算的鼻腔下部容积比与实际术后的鼻腔下部容积比存在一定相关性。结论 (1)SITL且伴有特殊症状患者的鼻腔容积与其ENS6Q评分有显著相关性;(2)IMAP对鼻腔的作用不仅仅在于缩窄容积,更在于重新恢复了鼻腔黏膜的功能;(3)应用下鼻甲部分鼻腔容积的容积比来估算术后鼻腔的情况或许可以进一步改进IMAP手术。
Objective To explore the changes in nasal cavity volume-related physical parameters before and after the inferior meatus augmentation procedure(IMAP)in patients suffering from secondary inferior turbinate loss with special nasal symptoms(SITL)using a computed tomography(CT)-based three-dimensional(3D)modeling approach.Methods A retrospective collection of empty nose syndrome 6-item questionnaire(ENS6Q)scores and CT images was obtained from 20 SITL patients.Nasal cavity volume and nasal mucosal surface area were estimated using 3D modeling,and the estimated lower nasal cavity volume ratio was calculated and its correlation with ENS6Q score was analyzed.Furthermore,CT images of 11 SITL patients undergoing IMAP were analyzed before and after surgery.Nasal cavity volume and mucosal surface area were compared before and after IMAP,and the estimated lower nasal cavity volume and volume ratio were calculated by subtracting the intraoperative filler volume from the preoperative estimated nasal cavity volume.Recommendations for intraoperative filler volume were recommended based on these calculations.Results After IMAP surgery,the total ENS6Q scores of SITL patients were significantly decreased,and all less than 11 points(P=0.003),but remained significantly higher than those of the healthy control group.In terms of volume,IMAP significantly reduced the estimated lower nasal cavity volume ratio in SITL patients(P=0.021),and the postoperative volume ratio was significantly indifferent from the healthy control group.Regarding mucosal surface area,the estimated lower nasal cavity mucosal surface area significantly decreased after IMAP(P=0.021).However,the difference of mucosal surface area between the postoperative SITL patients and the healthy control group remained significant,similar to the preoperative one.There was a certain correlation between the estimated and actual postoperative lower nasal cavity volume ratios.Conclusions There is a significant correlation between nasal cavity volume and ENS6Q scores in SITL patient
作者
罗元博
江晨艳
史方泽
孙与幸
陈斌
阎小军
易彬
石润杰
LUO Yuanbo;JIANG Chenyan;SHI Fangze;SUN Yuxing;CHEN Bin;YAN Xiaojun;YI Bin;SHI Runjie(Department of Otolaryngology Head and Neck Surgery,Shanghai Ninth People’s Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China;Shanghai Key Laboratory of Translational Medicine for Ear and Nose Diseases,Shanghai 200011,China)
出处
《中国耳鼻咽喉颅底外科杂志》
CAS
CSCD
2024年第2期32-39,共8页
Chinese Journal of Otorhinolaryngology-skull Base Surgery
基金
中央高校基本科研业务费专项资金资助(YG2021ZD16)
上海市耳鼻疾病转化医学重点实验室资助(14DZ2260300)。
关键词
下鼻甲继发性缺失
CT影像建模
鼻腔容积
下鼻道填充术
Special inferior turbinate loss
Computed tomographic image modeling
Nasal volume
Inferior meatus augmentation procedure
