背景:鼻和鼻旁窦异常可能与鼻泪管阻塞性疾病有关,但仍存在强烈争议。缺乏急性疾病阶段的数据。
目的:本研究的目的是确定鼻窦炎症的影像学征象与急性泪囊炎(AD)之间是否存在相关性。
方法:这项横断面对照研究在温州进行,浙江省,中国从2021年2月到2023年11月。连续44例AD患者和50例眼眶肿瘤患者(对照组),完成术前计算机断层扫描的人,通过改良的Lund-Mackay评分系统评估其炎症性鼻窦疾病的程度。
结果:鼻旁窦的炎症体征(总平均窦评分,95%CI[0.00,2.00];P<0.001),即前筛窦(95%CI[0.00,1.00];P<0.001),筛窦后部(95%CI[0.00,0.00];P=0.003),额窦(95%CI[0.00,0.00];P=0.02),与对照组相比,AD患者的窦道复合体(P<0.001)更广泛。病程与筛前评分(P=0.03)和额叶评分(P=0.01)呈负相关。眼睑肿胀症状与筛前病变呈正相关(P=0.03)。窦口复合体(P=0.004),和总窦性评分(P=0.005)。
结论:发现炎症性鼻窦疾病在AD患者中更为常见,随着病程的延长而逐渐缓解。炎症的相互扩散,特别是在急性病程中,可能在泪道阻塞性疾病中起重要作用。
BACKGROUND: Nasal and paranasal sinus abnormalities may be related to nasolacrimal duct obstructive disease but are strongly debated. Data of acute disease stage are lacking.
OBJECTIVE: The purpose of this study was to determine if there are correlations between radiologic signs of sinus inflammation and acute dacryocystitis (AD).
METHODS: This cross-sectional controlled study was conducted at Wenzhou, Zhejiang Province, China from February 2021 to November 2023. Forty-four consecutive patients with AD and 50 consecutive patients with orbital tumors (the control group), who completed preoperative computed tomography scans, were enrolled to evaluate the extent of their inflammatory sinonasal disease by the modified Lund-Mackay score system.
RESULTS: The inflammation signs of the paranasal sinuses (total mean sinus scores, 95% CI [0.00, 2.00]; P < 0.001), namely the anterior ethmoid sinus(95% CI [0.00, 1.00]; P < 0.001), the posterior ethmoid sinus(95% CI [0.00, 0.00]; P = 0.003), the frontal sinus (95% CI [0.00, 0.00]; P = 0.02), and the ostiomeatal complex (P < 0.001) were more extensive in patients with AD when compared with the controls. The disease course was negatively correlated with the anterior ethmoid (P = 0.03) and frontal scores (P = 0.01). The symptom of eyelid swelling was positively correlated with the anterior ethmoid (P = 0.03), ostiomeatal complex (P = 0.004), and total sinus scores (P = 0.005).
CONCLUSIONS: Inflammatory sinus disease was found to be more frequent in patients with AD, which was gradually alleviated with the prolongation of the disease course. The mutual spread of inflammation particularly in the acute course may play an important role in lacrimal duct obstructive disease.