摘要
目的:探讨内镜鼻窦手术前CT评估前颅底周围解剖变化的临床价值及其与解剖分型的相关性。方法:回顾性分析139例内镜鼻窦手术患者的临床资料,对所有患者进行术前鼻窦CT评估,并采用Pearson和Spearman分析各CT参数及其与解剖分型的相关性。结果:139例患者的LLCP长度为(5.59±1.07)mm,LLCP-CP角为(65.97±9.05)°,嗅凹深度为(5.86±1.33)mm。Pearson分析显示,嗅凹深度和LLCP长度正相关(P<0.05);和LLCP-CP角负相关(P<0.05);LLCP长度和LLCP-CP角负相关(P<0.05)。139例患者中,LannoyⅠ型70例(50.36%)、Ⅱ型30例(21.58%)、Ⅲ型39例(28.06%);KerosⅠ型82例(58.99%)、Ⅱ型47例(33.81%)、Ⅲ型10例(7.19%);GeraⅠ型40例(28.78%)、Ⅱ型94例(67.63%)、Ⅲ型5例(3.60%)。LiuⅠ型146侧(52.52%)、Ⅱ型64侧(23.02%)、Ⅲ型10侧(3.60%)、Ⅳ型52侧(18.71%)、Ⅴ型6侧(2.16%)。额窦未发育10侧(3.60%),额窦气化Ⅰ度60侧(21.58%)、Ⅱ度200侧(57.19%)、Ⅲ度49侧(17.63%)。Spearman分析显示,鼻窦手术患者Keros分型与Lannoy分型等级正相关(r=0.397,P<0.05)。结论:内镜鼻窦手术前鼻窦CT评估对于评估颅底周围解剖变化具有重要临床价值,同时嗅凹深度、LLCP长度均与LLCP-CP角相关,Keros分型、Lannoy分型等级正相关。Lannoy、Keros、Gera、Liu和额窦气化分型可量化颅底周围解剖异变程度,对手术方案的制定和改善患者预后具有指导意义。
Objective:To evaluate the clinical value of anatomical changes around the skull base before endoscopic sinus surgery in order to improve the safety and efficacy of surgery.Methods:A retrospective analysis was conducted on the clinical data of 139 patients undergoing endoscopic sinus surgery.All patients underwent preoperative sinus CT evaluation,and Pearson and Spearman analyses were used to explore the correlation between various CT parameters and anatomical classification.Results:The length of LLCP in 139 patients was(5.59±1.07)mm,the angle of LLCP-CP was(65.97±9.05)°,and the depth of olfactory fossa was(5.86±1.33)mm.Pearson analysis showed that the depth of olfactory fossa was positively correlated with LLCP length(P<0.05),and negatively correlated with LLCP-CP angle(P<0.05),the length of LLCP was negatively correlated with the angle of LLCP-CP(P<0.05).Among 139 patients,70 were Lannoy type I(50.36%),30 were Lannoy type II(21.58%),and 39 were Lannoy type III(28.06%).82 cases(58.99%)of type I Keros patients,47 cases(33.81%)of type II patients,and 10 cases(7.19%)of type III patients.There were 40 Gera type I patients(28.78%),94 type II patients(67.63%),and 5 type III patients(3.60%).Liu type I had 146 sides(52.52%),type II had 64 sides(23.02%),type III had 10 sides(3.60%),type IV had 52 sides(18.71%),and type V had 6 sides(2.16%).10 cases(3.60%)had undeveloped frontal sinuses,with 60 cases(21.58%)had first degree frontal sinus gasification,200 cases(57.19%)had second degree frontal sinus gasification,and 49 cases(17.63%)had third degree frontal sinus gasification.Spearman analysis showed that there was a positive correlation between the Keros classification and Lannoy classification in patients undergoing sinus surgery(r=0.397,P<0.05).Conclusion:CT evaluation of the sinus before endoscopic sinus surgery has important clinical value in evaluating the anatomical changes around the skull base.At the same time,the depth of the olfactory fossa and the length of the LLCP are both correlated with the LLCP-CP angle,
作者
车福盈
臧志敏
孙书连
王恒
王昭迪
CHE Fu-ying;ZANG Zhi-min;SUN Shu-lian;WANG Heng;WANG Zhao-di(Department of Otolaryngology,Beijing Jingmei Group General Hospital,Beijing 102300,China)
出处
《川北医学院学报》
CAS
2024年第6期815-817,825,共4页
Journal of North Sichuan Medical College
基金
北京京煤集团总医院科研自主项目(ZZ2022-19)。
关键词
内镜鼻窦手术
颅底
CT评估
临床价值
Endoscopic sinus surgery
Base of the skull
CT evaluation
Clinical value
