Czyz Craig N, Bacon Thomas S, Stacey Andrew W, Cahill Eva N, Costin Bryan R, Karanfilov Boris I, Cahill Kenneth V
*Section Oculofacial Plastic and Reconstructive Surgery, Ohio University/OhioHealth, Columbus, Ohio, U.S.A.; †Department of Medical Education, Mount Carmel Health Systems, Columbus, Ohio, U.S.A.; ‡Department of Ophthalmology, University of Michigan, Ann Arbor, Michigan, U.S.A.; §Department of Biology, Wittenberg University, Springfield, Ohio, U.S.A.; ‖Department of Ophthalmology, William H. Havener Eye Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A.; and ¶The Sinus Institute of Ohio, Dublin, Ohio, U.S.A.
Ophthalmic Plast Reconstr Surg. 2016 Jan-Feb;32(1):11-6. doi: 10.1097/IOP.0000000000000392.
To investigate variation in aeration of the nasolacrimal drainage system between age groups and genders, and to report the reliability of repeated aeration grading and nasolacrimal canal measurements on CT.
Retrospective review of CT images from 92 individuals, 60 female and 32 male, was conducted by 3 independent reviewers for the presence of air within the nasolacrimal drainage system. Diameter and area measurements were also obtained at the smallest identifiable portion of the nasolacrimal canal by 2 independent reviewers.
When air is present on CT, it is seen more fully throughout the nasolacrimal system in men as compared to women. Age data demonstrate that patients from the third and fourth decade have significantly more aeration than older patients. Diameter and area of the nasolacrimal duct within the canal at its narrowest point revealed no correlation with sex, age, or nasolacrimal system aeration. Inter-reviewer reliability shows strong repeatability of aeration grading and nasolacrimal duct measurements between multiple reviewers.
The results suggest CT is reliable and repeatable modality to assess nasolacrimal system aeration and nasolacrimal duct diameter. Decreased aeration of the nasolacrimal system in females and the elderly mirrors epidemiologic trends for those at risk to develop primary acquired nasolacrimal duct obstruction. Variables in nasolacrimal drainage system anatomy, specifically nasolacrimal duct diameter and area, did not vary between sexes or age groups, suggesting aeration may be an overlooked variable in nasolacrimal system function.
研究不同年龄组和性别的鼻泪引流系统通气情况的差异，并报告CT上重复通气分级和鼻泪管测量的可靠性。
3名独立的评估者对92例个体（60例女性和32例男性）的CT图像进行回顾性分析，以确定鼻泪引流系统内是否存在空气。2名独立的评估者还在鼻泪管最小可识别部分进行了直径和面积测量。
CT显示有空气时，男性鼻泪系统中的空气比女性更充盈。年龄数据表明，30多岁和40多岁的患者通气情况明显比老年患者更多。鼻泪管最窄处的直径和面积与性别、年龄或鼻泪系统通气情况无关。评估者间的可靠性显示，多位评估者之间通气分级和鼻泪管测量具有很强的可重复性。
结果表明，CT是评估鼻泪系统通气和鼻泪管直径的可靠且可重复的方法。女性和老年人鼻泪系统通气减少反映了那些有发生原发性获得性鼻泪管阻塞风险人群的流行病学趋势。鼻泪引流系统解剖结构的变量，特别是鼻泪管直径和面积，在性别或年龄组之间没有差异，这表明通气情况可能是鼻泪系统功能中一个被忽视的变量。
