Kim Sung Hee, Oh Jin Seok, Jang Yong Ju
Department of Otorhinolaryngology-Head and Neck Surgery, National Medical Center, Seoul, Republic of Korea.
Department of Otolaryngology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Republic of Korea.
Ann Otol Rhinol Laryngol. 2020 Feb;129(2):122-127. doi: 10.1177/0003489419878453. Epub 2019 Sep 20.
Although the routine use of computed tomography (CT) is controversial, it is employed in the preoperative screening of patients undergoing septoplasty or septorhinoplasty. The aim of this study was to evaluate the incidence and radiological characteristics of incidentally found sinus pathologies on screening CT in patients who underwent elective septoplasty or septorhinoplasty.
We retrospectively reviewed the patients who underwent septoplasty and septorhinoplasty performed by a single surgeon (Y.J.J.) at Asan Medical Center between January 2016 and December 2017. CT images of 372 patients who had agreed to undergo preoperative CT were reviewed to determine the location and extent of incidental sinus opacifications.
Of the 372 patients, 107 (28.8%) showed incidental sinus lesions on CT images. Opacifications were mainly found in the maxillary sinus (73, 68.2%), followed by the ethmoid (34, 31.8%), sphenoid (10, 9.3%), and frontal (3, 2.8%) sinuses. The most common sinus lesion was retention cyst (55, 51.4%), and the second most common one was opacification and mucosal thickening (46, 43%). Other lesions such as osteoma (3, 2.8%), dental cyst (2, 1.9%), and mucocele (1, 0.9%) were rarely found.
In patients undergoing septoplasty or septorhinoplasty, the incidence of incidental sinus lesions was approximately 28.8% (107/372). This results indicate that preoperative CT in patients undergoing septoplasty or septorhinoplasty might be helpful to surgeons not only for better understanding the anatomical detail but also for detecting hidden paranasal sinus disease.
尽管计算机断层扫描（CT）的常规使用存在争议，但它仍被用于鼻中隔成形术或鼻 septorhinoplasty 患者的术前筛查。本研究的目的是评估在接受择期鼻中隔成形术或鼻 septorhinoplasty 的患者中，筛查 CT 上偶然发现的鼻窦病变的发生率和放射学特征。
我们回顾性分析了 2016 年 1 月至 2017 年 12 月在峨山医疗中心由单一外科医生（Y.J.J.）进行鼻中隔成形术和鼻 septorhinoplasty 的患者。对 372 名同意接受术前 CT 的患者的 CT 图像进行了回顾，以确定偶然鼻窦混浊的位置和范围。
在 372 名患者中，107 名（28.8%）在 CT 图像上显示有偶然的鼻窦病变。混浊主要见于上颌窦（73 例，68.2%），其次是筛窦（34 例，31.8%）、蝶窦（10 例，9.3%）和额窦（3 例，2.8%）。最常见的鼻窦病变是潴留囊肿（55 例，51.4%），第二常见的是混浊和黏膜增厚（46 例，43%）。其他病变如骨瘤（3 例，2.8%）、牙囊肿（2 例，1.9%）和黏液囊肿（1 例，0.9%）很少见。
在接受鼻中隔成形术或鼻 septorhinoplasty 的患者中偶然鼻窦病变的发生率约为 28.8%（107/372）。这些结果表明，鼻中隔成形术或鼻 septorhinoplasty 患者的术前 CT 不仅有助于外科医生更好地了解解剖细节，还有助于检测隐匿的鼻窦疾病。
