背景:这项研究旨在通过分析计算机断层扫描(CT)图像来描述骨性鼻泪管(BNLD)和相邻鼻腔结构的解剖细节,并探讨其对原发性获得性鼻泪管阻塞(PANDO)发展的影响。
方法:共有50例单侧PANDO患者接受泪囊鼻腔吻合术,平均年龄为57.96岁,包括在内。回顾术前CT图像以测量BNLD在入口和出口水平的前后直径和横向直径,以及沿管道的最小横向直径。分析矢状CT图像,将骨管的形状分为柱状,漏斗,耀斑,和沙漏。相关的鼻旁异常,包括鼻中隔偏曲(NSD),鼻窦炎,骨性下鼻甲和上颌窦内壁之间的角度,和下鼻甲的粘膜厚度,被调查了。
结果:分析了50张CT图像,在BNLD两侧测量的所有参数在PANDO和非PANDO侧之间没有显着差异,除了最小横向直径,在PANDO侧明显较小(p=0.002)。柱状BNLD在两侧最常见。两侧鼻旁异常的发生率没有显着差异;但是,隔膜向非PANDO侧的偏离更为常见(67.9%).
结论:BNLD的最小横向直径较小可能是PANDO的危险因素。鼻腔异常与PANDO之间的关联并不显著。
BACKGROUND: This study aimed to describe the anatomical details of the bony nasolacrimal duct (BNLD) and adjacent nasal structures by analyzing computed tomography (CT) images, and to investigate their effects on the development of primary acquired nasolacrimal duct obstruction (PANDO).
METHODS: A total of 50 patients with unilateral PANDO who underwent dacryocystorhinostomy, with a mean age of 57.96 years, were included. The preoperative CT images were reviewed to measure the anteroposterior and transverse diameters of the BNLD at the entrance and exit levels, as well as the minimum transverse diameter along the tract. The sagittal CT images were analyzed to classify the shape of the bony canals into columnar, funnel, flare, and hourglass. The associated paranasal abnormalities, including nasal septum deviation (NSD), sinusitis, angle between the bony inferior turbinate and medial wall of the maxillary sinus, and mucosal thickness of the inferior turbinate, were investigated.
RESULTS: Fifty CT images were analyzed, and all parameters measured on both sides of the BNLD were not significantly different between the PANDO and non-PANDO sides, except for the minimum transverse diameter, which was significantly smaller on the PANDO side (p = 0.002). Columnar-shaped BNLD was the most common on both sides. No significant difference was observed in the incidence of paranasal abnormalities between sides; however, deviation of the septum toward the non-PANDO side was more common (67.9%).
CONCLUSIONS: A small minimum transverse diameter of the BNLD may be a risk factor for PANDO. The association between nasal abnormalities and PANDO was not remarkable.