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Abstract：
To find out the anatomic variations of nose/paranasal sinuses and how they affect the sinuses in chronic rhinosinusitis (CRS). This observational cross-sectional study included adults with CRS, refractory to optimum medical management, planned for functional endoscopic sinus surgery (FESS). Pre-operative naso-endoscopy and computed tomography (CT) were utilized to estimate the extent of CRS, and to note the anatomic variations of the sinuses. The findings were corroborated within the practical scope of FESS. The anatomic variations were evaluated to establish how they affected the related sinus(es). Most of the 53 patients were young adults presenting with nasal obstruction (77%), discharge (76%) and headache (68%). On diagnostic naso-endoscopy, prominent agger bulge (83% of the nasal sides), prominent uncinate (18%), inferior turbinate hypertrophy (34%), concha bullosa (38%), mucopus and polyp in the middle meatus (51%, 19%; respectively), and gross septal deviation (55%) were noted. The spheno-ethmoid and frontal recesses were predominantly unremarkable. CT revealed inferior turbinate hypertrophy (38% of the nasal sides), agger (100%), and lateralized/collapsed uncinate (8%). Ethmoids and maxillary sinuses were diseased in 50% and 65% respectively, with blocked ostiomeatal complex in 32% and prominent bulla in 48%. Frontal and sphenoid sinuses were least involved (10%, 2%; respectively). Enlarged agger caused maxillary sinusitis (87%), whereas anterior ethmoiditis resulted from enlarged agger (100%), bulla (89%) and frontal cells (51%). Identification of the anatomic variations of the nose/paranasal sinuses through CT and naso-endoscopy (diagnostic, per-operative) is crucial to understand the pattern, extent and severity of the involvement of sinuses in CRS.
摘要：
目的了解鼻/鼻旁窦的解剖变异以及它们如何影响慢性鼻-鼻窦炎（CRS）的鼻窦。这项观察性横断面研究包括患有CRS的成年人，难以进行最佳医疗管理，计划用于功能性内窥镜鼻窦手术（FESS）。术前鼻内窥镜检查和计算机断层扫描（CT）用于估计CRS的程度。并注意鼻窦的解剖变化。这些发现在FESS的实际范围内得到了证实。对解剖变异进行了评估，以确定它们如何影响相关的窦。53例患者中大多数是患有鼻塞的年轻人（77％），出院(76%)和头痛(68%)。在诊断鼻内窥镜检查中，突出的隆起（83％的鼻侧），突出的钩突（18%），下鼻甲肥大（34%），大疱性外耳道（38%），中鼻道粘液和息肉(51%，19%；分别），和总间隔偏差(55%)。筛骨和额叶凹陷主要不明显。CT显示下鼻甲肥大（38％的鼻侧），阿格（100%），和横向化/塌陷的钩酸（8％）。筛骨和上颌窦的病变分别为50％和65％，32％的窦口复合体受阻，48％的大疱突出。额窦和蝶窦受累最少(10%，2%；分别）。上颌窦炎(87%)而前筛窦炎是由扩大的阿格（100％）引起的，大疱（89%）和额叶细胞（51%）。通过CT和鼻内窥镜检查识别鼻/鼻旁窦的解剖变异（诊断，每次手术)对于理解模式至关重要，CRS中鼻窦受累的程度和严重程度。
