鼻-鼻窦解剖变异在复发性急性鼻-鼻窦炎中的作用。

Department of Otolaryngology Head and Neck Surgery, West Virginia University, Morgantown, West Virginia, U.S.A.

School of Medicine, West Virginia University, Morgantown, West Virginia, U.S.A.

Laryngoscope. 2024 Aug;134(8):3489-3492. doi: 10.1002/lary.31388. Epub 2024 Mar 7.

OBJECTIVES

Prior studies evaluating the role of sinonasal anatomic variants with recurrent acute rhinosinusitis (RARS) are limited by inconsistent results. The goal of this study is to evaluate the association between sinonasal anatomic variants and RARS.

METHODS

A 1:2 retrospective case-control study was conducted using patients presenting to the rhinology clinic from August 2020 to January 2023. A total of 60 patients with RARS were compared to 120 control patients. RARS was diagnosed based on the International Consensus Statement on Allergy and Rhinology criteria of four or more independent episodes of acute rhinosinusitis per year with at least one episode documented by objective findings, with complete resolution of the infection in-between episodes. Sinonasal anatomic variants included nasal septal deviation (NSD), concha bullosa (CB), infraorbital (Haller) cells, nasal septal spur in the middle meatus, and frontal sinus cells (supra-agger, supra-agger frontal, and suprabullar frontal cells).

RESULTS

Age was similar in RARS and control patients (47.4 ± 16.5 vs. 49.3 ± 14.5, p = 0.432). Both the RARS group and control group were more likely to be female (78.3% vs. 77.5%, p = 0.899). There was no significant association between NSD and RARS compared to the control group (OR = 0.97, p = 0.916), and no significant association between any of the anatomic variants and RARS [infraorbital cells (OR = 0.64, p = 0.167), CB (OR = 0.84, p = 0.596), spur in the middle meatus (OR = 1.28, p = 0.514), supra-agger (OR = 0.88, p = 0.708), supra-agger frontal cells (OR = 0.97, p = 0.939), or suprabullar frontal cells (OR = 1.13, p = 0.766)].

CONCLUSION

Our findings suggest no association between nasal septal deviation or any of the anatomic variants studied and RARS.

LEVEL OF EVIDENCE

3 Laryngoscope, 134:3489-3492, 2024.

目的

先前评估与复发性急性鼻-鼻窦炎（RARS）相关的鼻-鼻窦解剖变异的研究结果不一致。本研究旨在评估鼻-鼻窦解剖变异与 RARS 之间的关系。

方法

采用 2020 年 8 月至 2023 年 1 月在鼻科诊所就诊的患者进行了 1:2 的回顾性病例对照研究。将 60 例 RARS 患者与 120 例对照患者进行比较。RARS 根据国际过敏和鼻科学共识声明标准诊断，每年有 4 次或更多次独立的急性鼻-鼻窦炎发作，至少有 1 次发作有客观发现，发作之间感染完全消退。鼻-鼻窦解剖变异包括鼻中隔偏曲（NSD）、泡状鼻甲（CB）、眶下（Haller）细胞、中鼻甲鼻中隔突、额窦细胞（前上额窦、前上额窦和前眶下额窦细胞）。

结果

RARS 组和对照组患者的年龄相似（47.4±16.5 岁比 49.3±14.5 岁，p=0.432）。RARS 组和对照组患者均更可能为女性（78.3%比 77.5%，p=0.899）。与对照组相比，NSD 与 RARS 之间无显著相关性（OR=0.97，p=0.916），且任何解剖变异与 RARS 之间均无显著相关性[眶下细胞（OR=0.64，p=0.167）、CB（OR=0.84，p=0.596）、中鼻甲鼻中隔突（OR=1.28，p=0.514）、前上额窦（OR=0.88，p=0.708）、前上额窦细胞（OR=0.97，p=0.939）或前眶下额窦细胞（OR=1.13，p=0.766）]。