Subbotina M V, Kokhanov V S
Irkutsk State Medical University, Irkutsk, Russia.
Vestn Otorinolaringol. 2021;86(3):78-83. doi: 10.17116/otorino20218603178.
To determine the impact of various types of unilateral nasal septum deviation (NSD), (CB) and hypertrophic inferior turbinate (HIT) on the development of sinusitis.
This study was conducted in the Irkutsk State Medical University and the Irkutsk City Clinical Hospital No. 1 from October 2017 to November 2018. By continuous sampling retrospective analysis of 1300 protocols of paranasal sinuses MSCT of adult patients was performed. We used MSCT scanners Somatom Emotion 16 Siemens and GE BrightSpeed 16. The studies were carried out on the patients lying on the back with the subsequent reconstruction on a graphical station in the coronal and axial projections using the slices around 1 mm in the thickness. Inclusion criteria: unilateral or absence NSD. Exclusion criteria: bilateral NSD, chronic polyposis or allergic rhinitis. We have analyzed 272 protocols: 70 without NSD and 172 with unilateral NSD, on the right side - 89 (52%) and on the left - 83 (48%). 108 (44.6%) patients were male and 134 (55.4%) were female with average age 38.5±12 years. All patients were divided into 4 groups by R. Mladina' classification (1987): with NSD types 1, 2, 3, and 5. The results were evaluated using the Yates corrected chi-square and the Fisher's exact test by Statistica 10.0.
There were 34 patients with NSD type 1: 12 with sinusitis; 9 had CB: 6 with sinusitis, 3 without it; HIT was in 27 cases: 33% with sinusitis, 67% without it. There were 69 patients with NSD type 2: 12 had sinusitis; 22 had CB: 5 with sinusitis, 17 without it; HIT was in 42 cases: 26% with sinusitis, 74% without it. There were 43 patients with NSD type 3: 26 had sinusitis; 15 had CB: 6 with sinusitis, 9 without it; 30 had HIT: 57% with sinusitis, 43% without it. There were 26 patients with NSD type 5: 11 had sinusitis; 9 had CB: 3 with sinusitis, 6 without it; 24 had HIT: 42% with sinusitis, 58% without it. NSD type 2 was statistically significant prevailed in patients without sinusitis (=0.000005); NSD type 3 (=0.03) and the combination of NSD type 1 with contralateral CB (=0.04) prevailed in patients with sinusitis.
NSD type 3 (by R. Mladina), as well as the combination of type 1 with contralateral CB are have influence to the development of sinusitis. CB and HIT are statistically significant prevailed on the contralateral side to unilateral NSD, but do not affect to development of sinusitis.
确定各种类型的单侧鼻中隔偏曲(NSD)、鼻甲弯曲(CB)和下鼻甲肥大(HIT)对鼻窦炎发展的影响。
本研究于2017年10月至2018年11月在伊尔库茨克国立医科大学和伊尔库茨克市第一临床医院进行。通过连续抽样对1300例成年患者的鼻窦MSCT检查记录进行回顾性分析。我们使用了西门子Somatom Emotion 16和GE BrightSpeed 16 MSCT扫描仪。研究在患者仰卧位时进行,随后在图形工作站上以厚度约1mm的切片在冠状面和轴位进行重建。纳入标准:单侧或无鼻中隔偏曲。排除标准:双侧鼻中隔偏曲、慢性息肉病或过敏性鼻炎。我们分析了272份记录:70例无鼻中隔偏曲,172例单侧鼻中隔偏曲,右侧89例(52%),左侧83例(48%)。108例(44.6%)为男性,134例(55.4%)为女性,平均年龄38.5±12岁。所有患者根据R. Mladina(1987年)分类法分为4组:鼻中隔偏曲1型、2型、3型和5型。结果采用Yates校正卡方检验和Statistica 10.0软件的Fisher精确检验进行评估。
鼻中隔偏曲1型患者34例:12例患鼻窦炎;9例有鼻甲弯曲:6例患鼻窦炎,3例未患;27例有下鼻甲肥大:33%患鼻窦炎,67%未患。鼻中隔偏曲2型患者69例:12例患鼻窦炎;22例有鼻甲弯曲:5例患鼻窦炎,17例未患;42例有下鼻甲肥大:26%患鼻窦炎,74%未患。鼻中隔偏曲3型患者43例:26例患鼻窦炎;15例有鼻甲弯曲:6例患鼻窦炎,9例未患;30例有下鼻甲肥大:57%患鼻窦炎,43%未患。鼻中隔偏曲5型患者26例:11例患鼻窦炎;9例有鼻甲弯曲:3例患鼻窦炎,6例未患;24例有下鼻甲肥大:42%患鼻窦炎,58%未患。鼻中隔偏曲2型在无鼻窦炎患者中占统计学显著优势(P = 0.000005);鼻中隔偏曲3型(P = 0.03)以及鼻中隔偏曲1型与对侧鼻甲弯曲的组合(P = 0.04)在有鼻窦炎患者中占优势。
R. Mladina分类法中的鼻中隔偏曲3型以及1型与对侧鼻甲弯曲的组合对鼻窦炎的发展有影响。鼻甲弯曲和下鼻甲肥大在单侧鼻中隔偏曲的对侧占统计学显著优势,但不影响鼻窦炎的发展。