中鼻甲气化的CT分析

丰云峰

(金华市第五医院,浙江 金华 321001)

·基础与临床研究·

中鼻甲气化的CT分析

丰云峰

(金华市第五医院,浙江 金华 321001)

目的：了解中鼻甲气化的发病情况，探讨中鼻甲气化的CT表现及其临床意义，为鼻内窥镜检查术前提供解剖学依据。方法搜集173例患者的副鼻窦CT冠状位扫描图像及临床资料，从中找出中鼻甲气化患者进行分析。结果173例患者中发现中鼻甲气化65例，103侧，发生率为37.57%；双侧气化38例，单侧气化27例；垂直部气化91侧，球部气化3侧，广泛型气化9侧；形态以条状多见，大小平均约4mm×9mm；41例伴有鼻中隔偏曲，44例伴发鼻窦炎，14侧气化中鼻甲内见炎症改变，有3例气化之中鼻甲与鼻中隔接触。结论CT能明确显示中鼻甲气化情况，较大鼻甲泡与鼻窦炎有一定关系，也是引起头痛的原因之一。CT冠状位扫描对鼻内窥镜手术有指导价值。

中鼻甲；气化；体层摄影术，X线计算机

Abstract：[Objective] To analyze the prevalence of middle turbinate gasification and investigate the CT images and its clinical significance in order to provide anatomical basis for preoperative nasal endoscopic examination.[Method] We collected the paranasal sinus coronal CT scan images of 173 patients and clinical data to find out the middle turbinate gasification patients and analyze.[Result] 65 cases of middle turbinate gasification with 103 sides among these 173 patients were found. The incidence of middle turbinate gasification was 37.57%. 38 cases were bilateral gasification and 27 cases were unilateral gasification. Vertical lamina gasification, globuspart gasification and extensive gasification were 91, 3 and 9 sides, respectivelly. The anatomy was mainly strip. The average size was about 4 mm x 9 mm. 41 cases associated with nasal septum deviation and 44 cases combined with the sinusitis. Inflammation was detected in 14 sides gasification in the middle turbinate. 3 cases of the middle turbinate gasification contact with the nasal septum. [Conclusion] CT scan can clearly show the middle turbinate gasification .There is a relationship between the large concha bullosa and the sinusitis. This is also one of the reasons that can cause headaches. Coronal CT scan of the paranasal sinuses has guiding value to endoscopic sinus surgery.

Keywords: middle turbinate;gasification;tomography,X-ray computed

随着内窥镜鼻窦外科的发展，功能性鼻内窥镜手术(Functional Endoscopic Sinus Surgery ,FESS)成为治疗慢性和复发性鼻窦炎的有效手段，术前了解窦口鼻道复合体(Ostiomeatal Complex,OMC)区解剖变异情况对制定手术方案，避免术中发生严重并发症具有重要的意义。中鼻甲气化是指中鼻甲骨质内有气腔形成，又称鼻甲泡(Concha Bullosa,CB)，是OMC区常见的解剖变异之一。CT扫描可以提供鼻及鼻窦较为准确客观的影像学特征，为临床鼻内镜手术方案提供解剖学参考。本文对65例中鼻甲气化的临床和CT资料进行分析并探讨其临床意义。

1 资料与方法

1.1 一般资料

收集2009年10月至2010年9月无鼻腔、鼻窦手术史，资料完整的鼻窦CT片173例，发现有中鼻气化者65例，男37例，女28例，男女比为1.32:1。……