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目的:采用高分辨多排螺旋CT研究鼻中隔和中鼻甲解剖变异,并评价它们对前组鼻副窦引流通道的影响。方法:回顾分析60例行鼻腔和副鼻窦高分辨多排螺旋CT检查患者的图像资料。其中男35例,女25例,平均年龄42岁。所有受试者均采用16排螺旋CT机行高分辨容积扫描,层面从硬腭至额窦上缘,准直0.75~1 mm,横断、冠状和矢状重建,层厚及层距均为1 mm。分别观察和统计鼻中隔和中鼻甲解剖变异的类型和发生率,并评价其与前组鼻副窦引流通道的关系。结果:60例中,共发现鼻中隔变异45例(75%),其中鼻隔偏曲45例(单向偏曲31例,双向偏曲14例);犁骨-软骨结合部畸形5例(肥大2例,脱位3例);鼻隔刺16例。中鼻甲变异共43例(71.7%),其中反曲15例;气化9例;双侧不对称20例(46.5%)。不对称中鼻甲中,增大一侧多见于鼻隔偏移方向的对侧,多数伴有不同程度的钩突移位和筛漏斗或鼻道狭窄。结论:鼻腔和中鼻甲不对称与鼻中隔偏曲关系密切,后者是导致前组鼻副窦引流通道中的关键部位--中鼻道和筛漏斗狭窄的重要原因。
OBJECTIVE: To study the anatomic variation of nasal septum and middle turbinate by high-resolution multi-slice spiral CT and evaluate their influence on the drainage channel of nasal sinus. Methods: A retrospective analysis of 60 cases of nasal and paranasal sinus high-resolution multi-slice spiral CT examination of the patient’s image data. Including 35 males and 25 females, average age 42 years old. All subjects underwent high-resolution volume scanning with a 16-slice spiral CT scanner, ranging from the hard palate to the superior margin of the frontal sinus with 0.75 to 1 mm collimators. Transverse, coronal and sagittal reconstruction were performed with 1 mm . The types and incidences of anatomical variations of the nasal septum and middle turbinate were observed and counted respectively. The relationship between them and the anterior and posterior sinus drainage channels was also evaluated. Results: Among the 60 cases, 45 cases (75%) were found nasal septal variation, including 45 cases of nasal septum deviation (unidirectional deviation in 31 cases and bifacial deviation in 14 cases); 5 cases of vomerus-cartilage junction deformity 2 cases, dislocation in 3 cases); nasal septum puncture in 16 cases. There were 43 cases of middle turbinate variant (71.7%), of which 15 cases were retroviral; 9 cases were gasification; 20 cases were bilateral asymmetry (46.5%). Asymmetric middle turbinate, the greater side more common in the opposite direction of the nasal septum deviation, most with varying degrees of hook shift and sieve funnel or nasal stenosis. CONCLUSIONS: The nasal and middle turbinate asymmetry is closely related to the deviation of the nasal septum, which is an important cause of the stenosis of the middle nasal passages and sieve funnels.