Chen Zhengming, Fan Jingping, Li Huimin, Ye Xiaodan, Xu Yifei
Department of Otolaryngology, the 411th Hospital of PLA, Shanghai, 20081, China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2011 Feb;25(3):119-22.
To make 3-D reconstruction of frontal recess by high speed spiral CT, which can be helpful to nasal endoscopic frontal sinus operation.
Fifty-one cases (102 laterals) of frontal recess 3-D reconstruction by 16 line high speed spiral CT were enrolled in the research, which included 58 laterals with chronic frontal sinusitis and 44 laterals of normal nasal sinus. The structure of frontal recess, the agger nasi and the adhere style of uncinate process were recognized. The parameter of frontal recess was measured. Finally the data of two groups were compared and analyzed.
CT 3-D reconstruction of frontal recess could display the frontal sinus, frontal endosome and frontal recess. The shape of frontal recess varied greatly in different cases, which depended on the near structure especially agger nasi and uncinate process. The difference of average Y axes inner diameter between agger nasi and frontal endosome was significant. The difference of average Y axes inner diameter between frontal endosome and anterior nasal spine, between the line of frontal endosome to anterior nasal spine and the line of Aeby's plane and between bhullar cell and anterior nasal spine were not significant in two groups.
The drainage flow of frontal recess depends on the near structures especially on the agger nasi and uncinate process. The prevalence of agger nasi is high, and the position of it is constancy, as far agger nasi can be an anatomic landmark of frontal sinus operation. The position of frontal endosome is constancy. The scalloped area from anterior nasal spine 50-60 degrees to the line of Aeby's plane and within 100 mm radius is safety section to nasal endoscopic frontal sinus operation. CT 3-D reconstruction of this area is helpful to avoid insult.
利用高速螺旋CT对额隐窝进行三维重建,以辅助鼻内镜下额窦手术。
选取51例(102侧)行16排高速螺旋CT额隐窝三维重建的患者,其中慢性额窦炎58侧,正常鼻窦44侧。观察额隐窝、鼻丘及钩突附着方式的结构,测量额隐窝相关参数,最后对两组数据进行比较分析。
额隐窝CT三维重建可显示额窦、额窦内口及额隐窝。不同病例额隐窝形态差异较大,主要取决于相邻结构,尤其是鼻丘和钩突。鼻丘与额窦内口平均Y轴内径差异有统计学意义。两组中额窦内口与前鼻棘之间、额窦内口至前鼻棘连线与Aeby平面连线之间、泡状细胞与前鼻棘之间的平均Y轴内径差异无统计学意义。
额隐窝引流取决于相邻结构,尤其是鼻丘和钩突。鼻丘出现率高,位置恒定,可作为额窦手术的解剖标志。额窦内口位置恒定。从前鼻棘向Aeby平面连线50 - 60度、半径100 mm范围内的扇形区域是鼻内镜下额窦手术的安全区域。该区域的CT三维重建有助于避免损伤。