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目的探讨多层螺旋CT扫描对上颌窦骨性间隔畸形的诊断价值。方法对64例经多层螺旋CT扫描确诊、手术证实的上颌窦骨间隔畸形患者的临床资料进行分析。结果 64例中,冠状分隔29例,水平分隔17例,斜行分隔14例,矢状分隔4例。双侧26例,单侧38例。上颌窦内骨性间隔所分成的腔隙有交通者41例,无交通者23例。根据多层螺旋CT扫描检查,患者分别接受了经上颌窦筛窦根治术和面正中揭翻进路行上颌窦、筛窦、蝶窦联合根治术。术后患者均痊愈出院,随访半年无复发。结论复发性鼻息肉和慢性鼻窦炎患者,术前多层螺旋CT扫描检查可有效地发现残余病变的范围和手术区的解剖异常,对术前手术设计,特别是对功能性鼻窦内窥镜手术具有重要的指导作用。上颌窦骨性间隔术前的确诊主要依赖于多层螺旋CT的轴位和重建后的冠、矢状位三个断面的图像。
Objective To investigate the diagnostic value of multi-slice spiral CT in the diagnosis of maxillary sinus osseous deformity. Methods The clinical data of 64 patients with confirmed maxillary sinus osteosynthesis confirmed by multi-slice spiral CT scan were analyzed. Results Among the 64 cases, there were 29 cases with coronal septum, 17 cases horizontally separated, 14 cases obliquely separated and 4 cases sagittally separated. Bilateral in 26 cases, unilateral in 38 cases. Maxillary sinus space separated into lacuna 41 cases of traffic, 23 cases of no-traffic. According to multi-slice spiral CT scan examination, the patients underwent maxillary sinus ethmoidectomy and facial median dissection into the maxillary sinus, ethmoid sinus and sphenoid sinus radical mastectomy respectively. Patients were cured after surgery, no recurrence six months follow-up. Conclusion In patients with recurrent nasal polyps and chronic sinusitis, preoperative multi-slice spiral CT scan can effectively detect the extent of residual lesions and anatomic abnormalities in the operation area. The preoperative design of the surgery, especially for endoscopic sinus surgery Has an important guiding role. The diagnosis of maxillary sinus osseous space preoperatively depends mainly on the images of three axial sections of the MSCT and the coronal and sagittal sections after reconstruction.