Cai Fangyu, Dong Dong, Zhao Yulin
Department of Rhinology,the First Affiliated Hospital of Zhengzhou University,450052,Zhengzhou,China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Mar;35(3):252-255. doi: 10.13201/j.issn.2096-7993.2021.03.013.
To investigate the relationship between the pneumatization degree of paranasal sinuses and skull base and the incidence of spontaneous cerebrospinal fluid rhinorrhea (SCSFR). Date of 107 patients with SCSFR were reviewed retrospectively. Using CT scans, investigator evaluated the pneumatization degree of paranasal sinuses and skull base, and compared classifications of various imaging characteristics between SCSFR group(case group) and nasal septum deviation group(control group), including frontal cells, Onodi cell, lateral recess of sphenoid sinus (LRSS), pneumatization of anterior clinoid process and pneumatization of posterior clinoid process. One hundred and eight fistulas are found among 107 cases. The most common site of the fistulas is found in ethmoid sinus (38.89%), followed by olfactory cleft(37.04%), sphenoid sinus (21.30%) and frontal sinus (2.77%).The incidence of Onodi cell was significantly different between case and control group(²=4.755, <0.05), and the classification of Onodi cell has a linear effect on the occurrence of SCSFR (=3.345, <0.05), which suggests the increasing level of Onodi cell can increase the probability in occurrence of SCSFR. The incidence of type Ⅲ LRSS in the case group is significantly higher than in the control group(²=18.725, <0.05),a linear correlation is found between the classification of LRSS and the incidence of SCSFR (=3.578, <0.05).There was no significant difference in the incidence of frontal cells between the two groups(²=0.672, >0.05), nor was there a linear relationship between the classification of frontal cells and the incidence of SCSFR (=0.503, >0.05). Pneumatization of anterior clinoid process and posterior clinoid process were no significant difference between case and control (>0.05),nor were there linear relationships between their classifications and SCSFR (>0.05). The most common site of SCSFR is ethmoid sinus, followed by olfactory cleft,the hyperpneumatization of the LRSS and Onodi cell are closely related to its pathogenesis.
探讨鼻窦及颅底气化程度与自发性脑脊液鼻漏(SCSFR)发生率之间的关系。回顾性分析107例SCSFR患者的资料。研究者利用CT扫描评估鼻窦及颅底的气化程度,并比较SCSFR组(病例组)和鼻中隔偏曲组(对照组)之间各种影像学特征的分类情况,包括额隐窝、Onodi气房、蝶窦外侧隐窝(LRSS)、前床突气化及后床突气化。107例患者中发现108处瘘口。瘘口最常见的部位是筛窦(38.89%),其次是嗅裂(37.04%)、蝶窦(21.30%)和额窦(2.77%)。病例组和对照组Onodi气房的发生率有显著差异(²=4.755,<0.05),且Onodi气房的分类对SCSFR 的发生有线性影响(=3.345,<0.05),这表明Onodi气房程度增加会增加SCSFR发生的概率。病例组Ⅲ型LRSS的发生率显著高于对照组(²=18.725,<0.05),LRSS的分类与SCSFR的发生率之间存在线性相关性(=3.578,<0.05)。两组额隐窝的发生率无显著差异(²=0.672,>0.05),额隐窝的分类与SCSFR的发生率之间也无线性关系(=0.503,>0.05)。前床突和后床突气化在病例组和对照组之间无显著差异(>0.05),其分类与SCSFR之间也无线性关系(>0.05)。SCSFR最常见的部位是筛窦,其次是嗅裂,LRSS和Onodi气房的过度气化与其发病机制密切相关。