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題 名 | 無鼻部症狀受檢者之鼻竇電腦斷層表現=Incidental Findings on Computed Tomographic Scans of the Paranasal Sinuses |
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作 者 | 黃威雄; 宋民仁; 洪培凱; | 書刊名 | 臺灣耳鼻喉頭頸外科雜誌 |
卷 期 | 40:6 民94.11-12 |
頁 次 | 頁217-221 |
分類號 | 416.87 |
關鍵詞 | 鼻竇電腦斷層; Lund-MacKay分數; 解剖學變異; Sinus computed tomography; Lund-MacKay score; Anatomical variation; |
語 文 | 中文(Chinese) |
中文摘要 | 背景:鼻竇電腦斷層(Computed Tomography, CT)是耳鼻喉科醫師最常使用的影像檢查之一,它可以幫助了解鼻竇的疾病狀況與解剖構造。在台灣並沒有關於普通人群的鼻竇電腦斷層的研究。本研究的目的就是希望建立本土一般人群鼻竇電腦斷層黏膜異常與解剖學表現的基本參考資料。 方法:本研究的對象是17歲以上的成年人,於2004年3月至2005年2月一年的期間,至本院進行頭頸部電腦斷層檢查,但檢查原因不是為了鼻腔與鼻竇的疾病。排除下列病人:頭頸部放射治療病史、鼻腔與鼻竇疾病與手術病史、最近半年內曾因鼻竇症狀而至耳鼻喉科就醫、顯著頭部外傷與顏面骨折的病人。根據Lund-MacKay的分期原則,記錄其黏膜腫脹程度。再依據Stammberger等人的鼻竇解剖學名詞定義,統計各種解剖學變異的發生機率。 結果:共107名(214側鼻竇)被納入本研究,其中男65名,女42名,平均年齡43.6 (17-80)歲。平均每一側鼻竇的Lund-MacKay分數為0.83分,95%信賴區間為0.62-1.04,分佈範圍0到8分,其中0分有131側,佔61.2% (131/214),有顯著異常(分數≥3分)的側數為22側,佔10.3% (22/214)。最多的異常部位是上頷竇,佔34.6% (74/214)。變異的解剖構造以氣泡狀(concha bullosa)中鼻甲最常見,共59側佔27.6%,其次是Haller cell有22側(10.3%),其他解剖構造變化包括鼻中隔彎曲37 名(34.6%),agger nasi cell有189側(88.3%)。鼻中隔彎曲顯著影響Lund-MacKay分數,達統計學上有意義的相關(p=0.01, t-test)。 結論:一般人群中,單側Lund-MacKay分數平均為0.83分,輕度的鼻竇黏膜增厚相當常見,尤其發生在上頷竇最多,未必代表有鼻竇炎,單側鼻竇的Lund-MacKay分數3分或以上比較能代表明顯的鼻竇發炎。本研究對象的一般人群中各種常見解剖學表現,只有鼻中隔彎曲會顯著影響Lund-MacKay分數。 |
英文摘要 | BACKGROUND: Sinus computed tomography (CT) is the most useful image study to demonstrate sinonasal disease and anatomy. We found no study about the findings of sinus CT of general population in the literature in Taiwan. Therefore, the aim of this study is to document the sinus mucosal abnormality and anatomical variations in CT of Taiwanese general population. MATERIALS AND METHODS: Between March 2004 and February 2005, patients who came for head and neck CT study were enrolled. The CT scan must include all sinuses. Patients who had history of head and neck irradiation, operations for sinonasal disease, otolaryngologists consultation in half year and significant facial trauma were excluded. The mucosal status was recorded according to Lund-MacKay scoring system. The anatomical variations were documented according to the definitions of Stammberger et al. RESULTS: A total of 107 patients (with 214 sets of sinuses) were recruited, including 65 males and 42 females. The average age was 43.6 (17-80) years. The mean Lund-MacKay score was 0.83(95% CI, 0.62-1.04). The range of score was 0 to 8. The score was 0 in 131 (61.2%) sets of sinuses. There were 22 (10.3%) sets of sinuses with significant abnormality (score≥3). The maxillary sinus was found with the highest percentage (34.6%) of abnormal mucosa. Concha bullosa was the most frequent anatomical variation, consisting of 27.6%. Haller cell was found in 10.3% of all sets of sinuses. Other anatomical findings included septal deviation (34.6%) and aggernasi cell (88.3%). The presence of nasal septal deviation was associated with higher Lund-MacKay score, with p=0.01 (t-test). CONCLUSION: The average Lund-MacKay score was 0.83. Mild mucosal thickening in sinuses was common, especially in maxillary sinuses. It did not necessarily imply real disease. Only when the score was 3 or higher in the same set of sinuses, they could be clearly defined as abnormal. Among the common anatomical presentations of sinus CT, nasal septal deviation was the only one significantly associated with higher Lund-MacKay score. |
本系統中英文摘要資訊取自各篇刊載內容。