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鼻中隔偏曲患者下鼻甲的不对称性及其对鼻通气手术的意义。

Asymmetry of inferior turbinate in patients with nasal septum deviation and its significance for nasal ventilation surgery.

机构信息

Department of Otorhinolaryngology Head and Neck Surgery, Beijing Chaoyang Hospital, Capital Medical University, No. 8, Gongti South Road, Chaoyang District, Beijing, 100020, China.

Department of Otorhinolaryngology, Beijing Huairou Hospital of University of Chinese Academy of Sciences, Beijing, 101400, China.

出版信息

Eur Arch Otorhinolaryngol. 2022 May;279(5):2423-2431. doi: 10.1007/s00405-021-07012-z. Epub 2021 Jul 24.

Abstract

PURPOSE

To investigate the asymmetry of the inferior turbinate (IT) in patients with nasal septum deviation (NSD).

METHODS

The paranasal sinus computed tomography (CT) of 100 patients with NSD were retrospectively investigated from February 2018 to December 2019. The thickness of IT, IT mucosa and IT bone, the distance between the IT and the midline were measured on both the concave and convex sides, and which correlation with NSD was analyzed.

RESULTS

The widths of the IT, IT bone and IT medial mucosa on the concave side were larger than those on the convex side (all P < 0.05). The distance from the IT and IT bone to the midline on the concave side was smaller than those on the convex side (P < 0.05, respectively). The degree of NSD had a negative correlation with the widths of the IT and IT bone on the convex side, and the distance between the IT and the midline on the concave side; and a positive correlation with the distance from IT and IT bone to the midline on the convex side, and IT mucosa thickness on the concave side (all P < 0.05).

CONCLUSION

The asymmetric IT width is mainly caused by both hypertrophies of the IT mucosa on the concave side and atrophy of the IT bone on the convex side. Therefore, during the surgery of nasal ventilation reconstruction, the IT on the convex side are suggested to be protected from intervention. In contrast, it is necessary to lateralize the IT bone and reduce the IT submucosal tissue on the concave side. However, routine excision of the IT bone is not recommended.

摘要

目的

研究鼻中隔偏曲(NSD)患者下鼻甲(IT)的不对称性。

方法

回顾性分析 2018 年 2 月至 2019 年 12 月 100 例 NSD 患者的鼻窦 CT 资料。测量 IT 厚度、IT 黏膜和 IT 骨、IT 与中线之间的距离在凹侧和凸侧,并分析与 NSD 的相关性。

结果

凹侧 IT、IT 骨和 IT 内侧黏膜的宽度大于凸侧(均 P<0.05)。凹侧 IT 和 IT 骨距中线的距离小于凸侧(P<0.05)。NSD 程度与凸侧 IT 和 IT 骨的宽度以及凹侧 IT 与中线的距离呈负相关,与凸侧 IT 和 IT 骨距中线的距离以及凹侧 IT 黏膜厚度呈正相关(均 P<0.05)。

结论

不对称性 IT 宽度主要是由凹侧 IT 黏膜肥厚和凸侧 IT 骨萎缩引起的。因此,在进行鼻通气重建手术时,建议保护凸侧 IT 不受干预。相比之下,有必要将 IT 骨向外侧化并减少凹侧 IT 黏膜下组织。但是,不建议常规切除 IT 骨。

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