Kagawa University, Faculty of Medicine, Department of Otolaryngology, Kita-gun, Miki-cho, Japan.
Kagawa University, Faculty of Medicine, Department of Otolaryngology, Kita-gun, Miki-cho, Japan.
Braz J Otorhinolaryngol. 2024 Sep-Oct;90(5):101463. doi: 10.1016/j.bjorl.2024.101463. Epub 2024 Jul 9.
An ethmoid-dominant shadow on computed tomography is an indicator of type 2 inflammation, and is one of the main items used to diagnose and classify the severity of eosinophilic chronic rhinosinusitis in the Japanese diagnostic criteria. Ethmoid sinus dominance is examined using the Lund-Mackay scoring system and may be overestimated due to scoring characteristics. We aim to investigate the accuracy of evaluations of ethmoid dominance using the conventional scoring system and the possibility of conducting an objective evaluation using a more detailed other scoring system.
Patients diagnosed with eosinophilic chronic rhinosinusitis and who underwent bilateral endoscopic sinus surgery were enrolled in the present study. Computed tomography was performed preoperatively on all subjects. The bilateral anterior and posterior ethmoid sinuses and bilateral maxillary sinus were scored, and the ethmoid-to-maxillary ratio was calculated using 3 different scoring systems: Lund-Mackay (each sinus score ranges between 0 and 2), simplified Zinreich (score ranging between 0 and 3), and Zinreich (score ranging between 0 and 5).
A total of 149 patients were eligible for the present study. Significant differences were observed in ethmoid-to-maxillary ratio evaluated by the 3 different scoring systems (2.4 ± 0.7, 3.0 ± 1.1, and 3.7 ± 2.2). Only 2 patients were negative for ethmoid dominance by the Lund-Mackay scoring system, while 14 were negative by the simplified-Zinreich and Zinreich scoring systems. Severity changed from the initial grade in 12 patients.
The present results confirmed a potential overestimation when only the Lund-Mackay scoring system was used to assess ethmoid dominance. Ethmoid dominance has been identified as one of the main predictive factors for the long-term postoperative outcomes of eosinophilic chronic rhinosinusitis and is included in the Japanese diagnostic criteria. A detailed evaluation of ethmoid dominance is desirable for more accurate evaluations of the severity and prognosis of eosinophilic chronic rhinosinusitis.
计算机断层扫描（CT）上的筛窦阴影是 2 型炎症的指标，也是日本诊断标准中用于诊断和分类嗜酸性慢性鼻-鼻窦炎严重程度的主要项目之一。筛窦优势通过 Lund-Mackay 评分系统进行检查，由于评分特征，可能会被高估。我们旨在研究使用传统评分系统评估筛窦优势的准确性，以及使用更详细的其他评分系统进行客观评估的可能性。
本研究纳入了被诊断为嗜酸性慢性鼻-鼻窦炎并接受双侧内镜鼻窦手术的患者。所有患者均在术前进行 CT 检查。对双侧前筛窦和后筛窦以及双侧上颌窦进行评分，并使用 3 种不同的评分系统计算筛窦与上颌窦的比值：Lund-Mackay（每个窦腔的评分范围为 0 至 2）、简化 Zinreich（评分范围为 0 至 3）和 Zinreich（评分范围为 0 至 5）。
共有 149 名患者符合本研究条件。3 种不同评分系统评估的筛窦与上颌窦比值存在显著差异（2.4±0.7、3.0±1.1 和 3.7±2.2）。仅 2 例患者 Lund-Mackay 评分系统筛窦优势为阴性，而简化 Zinreich 和 Zinreich 评分系统有 14 例为阴性。12 例患者的严重程度从初始等级发生变化。
本研究结果证实，仅使用 Lund-Mackay 评分系统评估筛窦优势时存在潜在的高估。筛窦优势已被确定为嗜酸性慢性鼻-鼻窦炎长期术后结局的主要预测因素之一，并被纳入日本诊断标准。详细评估筛窦优势对于更准确地评估嗜酸性慢性鼻-鼻窦炎的严重程度和预后是必要的。
Zotero 插件