Savranlar Ahmet, Uzun Lokman, Ugur Mehmet Birol, Mahmutyazicioglu Kamran, Ozer Tulay, Gundogdu Sadi
Department of Radiology, Faculty of Medicine, Zonguldak Karaelmas University, Kozlu, Zonguldak 67600, Turkey.
Eur J Radiol. 2005 Feb;53(2):182-8. doi: 10.1016/j.ejrad.2004.04.003.
Our aim was to determine whether inward or outward movement of the secretions in the paranasal sinuses due to nose blowing after nasal decongestion has any effect on the paranasal sinus computed tomography (CT) images in patients with sinusitis and to asses whether nose blowing may result in misdiagnosis or overdiagnosis in radiological evaluation of sinusitis.
Twenty-four patients with chronic sinusitis were evaluated in an academic tertiary care hospital and data were collected prospectively. After coronal sinus computed tomography scans were performed at 100 mA setting which was half the value of the standard radiation dose suggested by the manufacturer, topical decongestion was applied to each nostril followed by nose blowing 10 min later. Sinus CT scans were then repeated at the same setting. We evaluated the mucosal thickness of medial, lateral, superior and inferior maxillary and frontal sinus walls and the maximal thickness in anterior ethmoidal cells. The measurements prior to and following nose blowing were compared with Wilcoxon signed ranks test. The obtained images were also staged using Lund-McKay staging system separately and the scores were compared with Student's t-test.
We observed a tendency towards reduction in mucosal thickness after nose blowing. There were statistically significant differences between maxillary sinus inferior wall and frontal sinus inferior wall mucosal thickness values prior to and after nose blowing. The difference however was very small, about 0.5 mm in magnitude and Lund-McKay score did not change in any of the patients after nose blowing.
Nose blowing and topical nasal decongestion does not have any effect on the diagnostic accuracy of sinus CT in chronic sinusitis patients.
我们的目的是确定在鼻窦炎患者中，鼻充血后擤鼻导致鼻窦分泌物向内或向外移动是否会对鼻窦计算机断层扫描（CT）图像产生任何影响，并评估擤鼻是否会在鼻窦炎的放射学评估中导致误诊或过度诊断。
在一家学术性三级护理医院对24例慢性鼻窦炎患者进行评估，并前瞻性收集数据。在以100 mA设置进行冠状窦计算机断层扫描后（该值为制造商建议的标准辐射剂量的一半），对每个鼻孔进行局部减充血，10分钟后进行擤鼻。然后在相同设置下重复鼻窦CT扫描。我们评估了上颌窦和额窦内侧、外侧、上壁和下壁以及前筛窦的最大黏膜厚度。使用Wilcoxon符号秩检验比较擤鼻前后的测量值。所获得的图像还分别使用Lund-McKay分期系统进行分期，并将分数与学生t检验进行比较。
我们观察到擤鼻后黏膜厚度有减小的趋势。擤鼻前后上颌窦下壁和额窦下壁黏膜厚度值存在统计学显著差异。然而，差异非常小，幅度约为0.5毫米，并且擤鼻后所有患者的Lund-McKay评分均未改变。
擤鼻和局部鼻减充血对慢性鼻窦炎患者鼻窦CT的诊断准确性没有任何影响。
