Taneja Aman, Malhotra Ankur, Chandak Shruti, Jain Swasti, Taneja Arpit, Arora Deepti, Laxmi Swarna, Pandey Aishwarya
Department of Radiodiagnosis, Teerthankar Mahaveer Medical College and Research Center, Moradabad, Uttar Pradesh, India.
Department of Radiodiagnosis, Govind Ballabh Pant Hospital, New Delhi, India.
J Clin Imaging Sci. 2024 Nov 18;14:44. doi: 10.25259/JCIS_124_2024. eCollection 2024.
The study aimed to evaluate the relationship between maxillary sinus volume and various sinonasal anatomical variants, as detected by multi-detector computed tomography, and their associations with chronic rhinosinusitis (CRS).
A case-control study was conducted with 103 patients presenting with chronic sinonasal symptoms (cases) and 50 asymptomatic individuals (controls). A 128-slice computed tomography scanner was used to measure maxillary sinus volume and assess anatomical variants, such as a deviated nasal septum (DNS), concha bullosa (CB), and agger nasi cells. Exclusion criteria included previous sinonasal surgery, malignancy, craniofacial trauma, and lack of consent. Statistical analysis was performed using -tests for continuous variables and Chi-square tests for categorical data. Receiver operating characteristic curve analysis was utilized to determine a DNS angle cutoff for predicting CRS.
Anatomical variants were significantly more frequent in cases than in controls. The left-sided DNS was predominant in cases, while the right-sided DNS was more common in controls. The mean DNS deviation angle was notably larger in cases (10.84° ± 7.87) than in controls (5.55° ± 5.02). Maxillary sinus volume was significantly smaller in cases (9.69 cc on the left side and 10.23 cc on the right side) compared to controls (18.57 cc and 18.46 cc, respectively), with female patients exhibiting smaller volumes than males. Agger nasi cells were detected in 51.5% of cases versus 8.0% of controls. A strong association was found between CB and contralateral DNS. The optimal DNS deviation angle cutoff for predicting CRS was identified as 12.7°.
This study shows that CRS is linked to smaller maxillary sinus volumes, with males having larger sinus volumes than females. A DNS and larger deviation angles were associated with a higher risk of sinus inflammation, with angles over 12.7° predicting the onset of the condition. The presence of CB and agger nasi cells also contributed to the development of CRS.
本研究旨在评估通过多排螺旋计算机断层扫描检测到的上颌窦容积与各种鼻窦解剖变异之间的关系，以及它们与慢性鼻-鼻窦炎（CRS）的关联。
进行了一项病例对照研究，纳入103例有慢性鼻窦症状的患者（病例组）和50例无症状个体（对照组）。使用128层计算机断层扫描仪测量上颌窦容积并评估解剖变异，如鼻中隔偏曲（DNS）、泡性鼻甲（CB）和鼻丘气房。排除标准包括既往鼻窦手术史、恶性肿瘤、颅面外伤以及未获得同意。对连续变量采用t检验，对分类数据采用卡方检验进行统计分析。利用受试者工作特征曲线分析确定预测CRS的DNS角度临界值。
病例组的解剖变异明显比对照组更常见。病例组中左侧DNS占主导，而对照组中右侧DNS更常见。病例组的平均DNS偏斜角度（10.84°±7.87）明显大于对照组（5.55°±5.02）。与对照组（分别为18.57 cc和18.46 cc）相比，病例组的上颌窦容积明显更小（左侧为9.69 cc，右侧为10.23 cc），女性患者的容积比男性更小。51.5%的病例组检测到鼻丘气房，而对照组为8.0%。发现CB与对侧DNS之间存在强关联。预测CRS的最佳DNS偏斜角度临界值确定为12.7°。
本研究表明，CRS与较小的上颌窦容积有关，男性的窦腔容积大于女性。DNS和较大的偏斜角度与鼻窦炎症的较高风险相关，角度超过12.7°可预测该病的发生。CB和鼻丘气房的存在也促成了CRS的发展。
