利用计算机断层扫描分析鼻窦和筛窦顶的解剖变异。
An analysis of the anatomic variations of the paranasal sinuses and ethmoid roof using computed tomography.
作者信息
Kaplanoglu Hatice, Kaplanoglu Veysel, Dilli Alper, Toprak Ugur, Hekimoğlu Baki
机构信息
Department of Radiology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.
Department of Radiology, Ankara Numune Training and Research Hospital, Ankara, Turkey.
出版信息
Eurasian J Med. 2013 Jun;45(2):115-25. doi: 10.5152/eajm.2013.23.
OBJECTIVE
To determine the Keros classification and asymmetrical distribution rates of the ethmoid roof and the frequency of anatomic variations of the paranasal sinuses.
MATERIALS AND METHODS
Paranasal sinus scans of 500 patients obtained using computed tomography were evaluated retrospectively. Measurements were performed using a coronal plan with right-left comparison and with distance measurement techniques. The depth of the lateral lamella was calculated by subtracting the depth of the cribriform plate from the depth of the medial ethmoid roof. The results were classified according to their Keros classification. Any asymmetries in the ethmoid roof depth and fovea ethmoidalis configuration were examined. The anatomic variations frequently encountered in paranasal sinuses (pneumatized middle concha, paradoxical middle concha, agger nasi cells, Haller cells, Onodi cells, etc.) were defined.
RESULTS
The mean height of the lateral lamella cribriform plate (LLCP) was 4.92±1.70 mm. The cases were classified as 13.4% Keros Type I, 76.1% Keros Type II, and 10.5% Keros Type III. There was asymmetry in the LLCP depths of 80% of the cases, and a configuration asymmetry in the fovea in 35% of the cases. In 32% of the cases with fovea configuration asymmetry, there was also asymmetry in the height of the right and left LLCP. The most frequent variations were nasal septum deviation (81.8%), agger nasi cells (63.8%), intralamellar air cells (45%), and concha bullosa (30%).
CONCLUSION
Using the Keros classification for LLCP height, higher rates of Keros Type I were found in other studies than in our study. The most frequent classification was Keros Type II. The paranasal sinus variations in each patient should be carefully evaluated. The data obtained from these evaluations can prevent probable complications by informing rhinologists performing endoscopic sinus surgery about preoperative and intraoperative processes.
目的
确定筛窦顶的凯罗斯分类及不对称分布率以及鼻旁窦解剖变异的频率。
材料与方法
回顾性评估500例患者使用计算机断层扫描获得的鼻旁窦扫描图像。采用冠状面进行测量，并进行左右对比以及距离测量技术。通过从中鼻甲顶的深度减去筛板的深度来计算外侧薄板的深度。结果根据凯罗斯分类进行划分。检查筛窦顶深度和筛凹形态的任何不对称情况。明确鼻旁窦中常见的解剖变异（气化中鼻甲、反常中鼻甲、鼻丘气房、哈勒气房、Onodi气房等）。
结果
外侧薄板筛板（LLCP）的平均高度为4.92±1.70毫米。病例分类为凯罗斯I型占13.4%，凯罗斯II型占76.1%，凯罗斯III型占10.5%。80%的病例LLCP深度存在不对称，35%的病例筛凹形态存在不对称。在32%筛凹形态不对称的病例中，左右LLCP的高度也存在不对称。最常见的变异是鼻中隔偏曲（81.8%）、鼻丘气房（63.8%）、板内气房（45%）和泡状鼻甲（30%）。
结论
使用凯罗斯分类评估LLCP高度时，本研究中发现的凯罗斯I型比例低于其他研究。最常见的分类是凯罗斯II型。应仔细评估每位患者的鼻旁窦变异情况。从这些评估中获得的数据可以通过告知进行鼻内镜鼻窦手术的鼻科医生术前和术中过程，预防可能出现的并发症。
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