额窦中隔气房影像学及内镜下临床特征

Radiologic and endoscopic characteristics of frontal septal cell

摘要:

目的探讨额窦中隔气房(FSC)的影像学特征及内镜下临床特征。方法收集2016年7—12月鼻内镜手术术前鼻窦三维CT检查发现额窦中隔气房患者23例，按照Wormald额窦手术分型，行内镜下额窦手术，术中开放FSC，明确额窦引流通道与FSC的位置关系及临床特征。结果鼻窦CT影像学显示：FSC开口在额窦内6例，开口在额隐窝者17侧；FSC单个气房者16例，2个气房者7例；所有患者均行内镜下额窦手术, Wormald 3级手术17例， Wormald 5级手术3例（复发性鼻息肉病骨质硬化明显2例、复发性乳头状瘤1例），Wormald 6级手术1例；经额隐窝径路内镜下开放FSC 18例，经额窦底近中线开放FSC 5例。结论术前鼻窦CT三维重建，明确FSC及其与额窦引流通道影像学特征；内镜下经额隐窝径路或额窦底中线径路开放FSC，是额窦手术的重要步骤。

关键词:额窦中隔气房|内镜检查术|手术|X线计算机

Abstract:

ObjectiveTo explore the radiologic and endoscopic characteristics of frontal septal cell (FSC).MethodsFSC was confirmed via preoperative threedimensional computed tomographic (CT) scan of nasal sinus in 23 patients undergoing endoscopic sinus surgery in our department from July to Dec 2016. Their radiologic characteristics were analyzed. According to Wormald’s classification of frontal sinus endoscopic surgery (EFSS), all the 23 patients received FESS. FSCs were opened in different ways and the position relationship of the frontal sinus drainage passage and FSC was revealed.ResultsSinus CT showed that the FSC opened in the frontal sinus in 6 cases and to the frontal recess in 17. Single FSC was found in 16 cases, and two FSCs in 7. As for EFSS, Grade 3 of Wormald’s EFSS was performed in 19 cases, Grade 5 in 3 (2 with recurrent nasal polyposis and one with recurrent papilloma), and Grade 6 in one. FSC was opened through frontal recess in 19 cases and middle floor of frontal sinus in 4.ConclusionsPreoperative threedimensional reconstruction of sinus CT can reveal the features of FSC and frontal sinus drainage passage. The FSC can be opened through frontal recess or middle floor of frontal sinus, which is an important step in EFSS.

Key words:Frontal septal cell| Endscopy| Surgery| Computer tomography