Karpishchenko Sergei, Vereshchagina Olga, Stancheva Olga, Nagornykh Tatiana, Krasichkov Alexander, Serdiukova Irina, Sinitca Aleksandr, Kaplun Dmitry
ENT Department with Clinic, Pavlov First Saint Petersburg State Medical University, 195176 St. Petersburg, Russia.
Radio Engineering Systems Department, Saint Petersburg Electrotechnical University "LETI", 197022 St. Petersburg, Russia.
Diagnostics (Basel). 2022 May 21;12(5):1284. doi: 10.3390/diagnostics12051284.
Isolated sphenoid sinusitis (ISS) is a group of pathologies characterized by inflammation in one or both sphenoid sinuses. The gold standard for analyzing and diagnosing ISS is computer tomography. Many researchers have discussed the treatment of patients with ISS variants such as fully opacified sinus, mostly with surgery. A retrospective analysis of clinical data of 59 patients (21 male (35%), 38 female (65%)) with ISS, who were treated in the Otorhinolaryngological Department of Pavlov First Saint Petersburg State Medical University between January 2017 and January 2020, was conducted. All patients were in the first stage of the same medical therapy. In cases where there was no recovery, these patients were referred to surgery. For the control group, we analyzed patients without any disorders according to CT-scan examination. After analyzing the obtained clinical and radiological data, we found indicators that were common in patients who did not recover after medical therapy. According to the reverse regression method statistical model, in male patients with a diffuse headache and nasal discharge it was shown that medical therapy was highly effective (more than 78%). The presence of nasal septum deviation and adenoids in male and female patients leads to the highest risk of surgical treatment (83% probability of the logistic model). The detailed analysis of CT-scans and the complaints of patients with ISS can be the key to determining the preferred therapy choice. Not all cases need to have an endoscopic opening of the sphenoid sinus, according to our research.
孤立性蝶窦炎（ISS）是一组以一个或两个蝶窦炎症为特征的病症。分析和诊断ISS的金标准是计算机断层扫描。许多研究人员讨论了ISS变体患者的治疗方法，如完全闭塞的鼻窦，大多采用手术治疗。对2017年1月至2020年1月在圣彼得堡第一国立巴甫洛夫医科大学耳鼻喉科接受治疗的59例ISS患者（21例男性（35%），38例女性（65%））的临床资料进行了回顾性分析。所有患者均处于相同药物治疗的第一阶段。在未康复的情况下，这些患者被转诊进行手术。对于对照组，我们根据CT扫描检查分析了无任何疾病的患者。在分析获得的临床和放射学数据后，我们发现了药物治疗后未康复患者的常见指标。根据反向回归方法统计模型，在患有弥漫性头痛和流涕的男性患者中，药物治疗显示出高效（超过78%）。男性和女性患者中鼻中隔偏曲和腺样体的存在导致手术治疗的风险最高（逻辑模型概率为83%）。对CT扫描和ISS患者的主诉进行详细分析可能是确定首选治疗方案的关键。根据我们的研究，并非所有病例都需要进行蝶窦的内镜开放手术。
