Numminen Jura, Dastidar Prasun, Rautiainen Markus
Department of Otorhinolaryngology, Head and Neck Surgery, Tampere University Hospital and Tampere University, Tampere, Finland.
J Otolaryngol. 2004 Apr;33(2):98-103. doi: 10.2310/7070.2004.02092.
The objectives of this prospective study were to clarify how well acoustic rhinometry (AR), computed tomography volumetry (CTV), rhinomanometry (RMM), and the visual analogue scale (VAS) identify changes in intranasal pathology after endoscopic sinus surgery in patients with chronic sinusitis. The measurements were performed in 44 nasal cavities of 11 patients pre- and postoperatively, 6 of whom underwent middle meatal antrostomy and 5 of whom underwent ethmoidectomy. The AR and RMM results were compared with those obtained with CTV and VAS. Furthermore, a favourable outcome in sinus surgery was obtained with all of the methods. The results showed clearly that endoscopic sinus surgery significantly changes the intranasal geometry and can be obtained reliably using rhinometric measurements. Both AR and CTV identified statistically significant (p < .05) volume changes in the nasal cavities. The AR and CTV results correlated generally well (r = .72) with each other, but wide differences were seen between the operative groups. Correlation in the ethmoidectomy group was very strong (r = .93) but weak in the middle meatal antrostomy group (r = .37). In the nasal function measurements, nasal obstruction decreased significantly (p < .05) after the surgery. The changes were clearly obtained using RMM and VAS (p < .05). Correlation between these methods was generally poor (r < .30), but a difference was again seen in the operative groups. In the ethmoidectomy group, correlation was moderately good (r = .55) but weak in the middle meatal antrostomy group (r = .29). We concluded that rhinometric methods are reliable tools for evaluation of operative outcome in endoscopic sinus surgery patients. Inspiratory resistance measured with RMM and nasal obstruction assessed with VAS appeared to measure separate parameters in nasal function.
这项前瞻性研究的目的是阐明声学鼻测量法（AR）、计算机断层扫描容积测量法（CTV）、鼻测压法（RMM）和视觉模拟评分法（VAS）在慢性鼻窦炎患者内镜鼻窦手术后识别鼻内病变变化方面的效果如何。对11例患者的44个鼻腔在术前和术后进行了测量，其中6例接受了中鼻道上颌窦造口术，5例接受了筛窦切除术。将AR和RMM的结果与CTV和VAS的结果进行了比较。此外，所有方法在鼻窦手术中均取得了良好的效果。结果清楚地表明，内镜鼻窦手术显著改变了鼻内结构，并且可以通过鼻测量法可靠地获得相关结果。AR和CTV均识别出鼻腔内具有统计学意义（p < 0.05）的容积变化。AR和CTV的结果总体上相关性良好（r = 0.72），但不同手术组之间存在较大差异。筛窦切除术组的相关性非常强（r = 0.93），而中鼻道上颌窦造口术组的相关性较弱（r = 0.37）。在鼻功能测量中，术后鼻阻塞显著降低（p < 0.05）。使用RMM和VAS清楚地获得了这些变化（p < 0.05）。这些方法之间的相关性总体较差（r < 0.30），但不同手术组之间再次出现差异。在筛窦切除术组中，相关性中等良好（r = 0.55），而在中鼻道上颌窦造口术组中相关性较弱（r = 0.29）。我们得出结论，鼻测量法是评估内镜鼻窦手术患者手术效果的可靠工具。用RMM测量的吸气阻力和用VAS评估的鼻阻塞似乎测量的是鼻功能中的不同参数。
