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目的:探讨儿童腺样体肥大与分泌性中耳炎、鼻窦炎的CT表现及其相关性。方法:对81例经临床手术病理证实为腺样体肥大且术前进行鼻咽部CT扫描(同时具有鼻窦炎或/和分泌性中耳炎)的临床影像学资料进行回顾性分析,根据腺样体肥大程度分为两组:中度肥大(33例)和重度肥大(48例),分析两组间分泌性中耳炎和鼻窦炎发病率的差异性和影像学特征。结果:中度肥大组伴发病变的CT表现为:上颌窦炎26例(24.7%),筛窦炎17例(16.2%),额窦炎3例(2.8%),蝶窦炎7例(6.6%),鼻甲肥大30例(28.6%),外耳道炎3例(2.8%),鼓室炎23例(21.9%),乳突窦炎23例(21.9%);重度肥大组伴发病变的CT表现为:上颌窦炎45例(42.8%),筛窦炎43例(40.9%),额窦炎11例(10.5%),蝶窦炎14例(13.3%),鼻甲肥大44例(41.9%),外耳道炎5例(4.7%),鼓室炎40例(46.7%)。乳突窦炎40例(46.7%)。81例中56例(71%)同时合并有鼻窦炎、分泌性中耳炎。结论:腺样体肥大与分泌性中耳炎和鼻窦炎发病率呈正相关,重度肥大组分泌性中耳炎和鼻窦炎发病率明显高于中度肥大组,双侧发病率高于单侧。
Objective: To investigate the CT findings of adenoid hypertrophy and secretory otitis media and sinusitis in children. Methods: The clinical data of 81 cases with adenoid hypertrophy confirmed by clinical pathology and nasopharyngeal CT scan before surgery (with sinusitis and / or otitis media with effusion) were retrospectively analyzed. According to the adenoid The degree of hypertrophy was divided into two groups: moderate hypertrophy (33 cases) and severe hypertrophy (48 cases). The differences and imaging features of the incidence of secretory otitis media and sinusitis between the two groups were analyzed. Results: The CT findings of moderate hypertrophy group were: maxillary sinusitis in 26 cases (24.7%), ethmoid sinusitis in 17 cases (16.2%), frontal sinusitis in 3 cases (2.8%), sphenoid sinusitis in 7 cases 6.6%), turbinate hypertrophy in 30 cases (28.6%), otitis externa in 3 cases (2.8%), tympanitis in 23 cases (21.9%) and mastoid sinusitis in 23 cases 45 cases (42.8%) of maxillary sinusitis, ethmoid sinusitis in 43 cases (40.9%), frontal sinusitis in 11 cases (10.5%), sphenoidal sinusitis in 14 cases (13.3%) and turbinate hypertrophy in 44 cases (41.9% ), 5 cases of otitis externa (4.7%) and tympanitis (46.7%). Mastoid sinusitis in 40 cases (46.7%). In 81 cases, 56 cases (71%) also had sinusitis and otitis media with otitis media. Conclusions: The incidence of adenoid hypertrophy and secretory otitis media is positively correlated with the incidence of sinusitis. The incidence of secretory otitis media and sinusitis in severe hypertrophy group is significantly higher than that in moderate hypertrophy group, and the bilateral incidence rate is higher than that in unilateral.