目的:空鼻综合征(ENS)是一种相对罕见的疾病,极大地影响了生活质量,并提出了诊断挑战。我们试图确定ENS患者特有的客观临床发现,在这样做的过程中,以交替的方式确定了代偿性粘膜肥大,在内窥镜检查和冠状计算机断层扫描(CT)上起伏的肿胀,我们称之为“蛇形标志”。\"这里,我们调查了这一影像学发现是否是ENS患者的可靠表现.
方法:进行回顾性审查,以确定ENS患者过去鼻甲成形术,ENS6Q评分至少为11/30,棉花放置试验症状改善。确定没有ENS症状(ENS6Q<11)的对照患者进行比较。ENS和对照组患者的冠状CT成像可用于评估蛇纹石征,以及ENS6Q分数,鼻组织的组织学分析。
结果:评估了34名ENS和74名对照患者是否存在蛇纹石征。在34名ENS患者中,与74例对照患者中的0例(p<0.0001)相比,18例在CT成像上表现出这种射线照相发现(52.9%)。进一步的分析表明,有蛇纹石征的ENS患者在ENS6Q上的中位数得分低于无蛇纹石征的ENS患者(17.5vs.22,p=0.033)。组织学显示,上皮下上皮杂乱无章,富含类似于鼻中隔肿胀体的浆膜黏液腺。
结论:“蛇形征”是ENS患者特有的鼻中隔软组织肥厚性改变的独特表现,可作为可靠的影像学和内镜诊断结果。
方法:IV喉镜,2023年。
Empty nose syndrome (
ENS) is a relatively uncommon disease that greatly impacts the quality of life and presents diagnostic challenges. We sought to identify objective clinical findings unique to patients with
ENS, and in doing so identified compensatory mucosal hypertrophy in an alternating, undulating swelling on endoscopy and coronal computerized tomography (CT) that we have termed the \"Serpentine Sign.\" Here, we investigated whether this radiographic finding is a reliable manifestation in ENS patients.
Retrospective review was undertaken to identify ENS patients with past turbinoplasty, an ENS6Q score of at least 11/30, and symptomatic improvement with the cotton placement test. Control patients without complaints of
ENS symptoms (ENS6Q < 11) were identified for comparison. ENS and control patients had coronal CT imaging available to evaluate for the Serpentine Sign, as well as ENS6Q scores, and histologic analysis of nasal tissue.
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ENS and 74 control patients were evaluated for the presence of the Serpentine Sign. Of the 34 patients with ENS, 18 exhibited this radiographic finding on CT imaging (52.9%) compared to 0 of the 74 control patients (p < 0.0001). Further analysis demonstrated that ENS patients with the Serpentine Sign had lower median scores on ENS6Q than
ENS patients without (17.5 vs. 22, p = 0.033). Histology revealed disorganized subepithelium rich in seromucinous glands similar to the nasal septum swell body.
The \"Serpentine Sign\" is a unique presentation of hypertrophic change to the nasal septum soft tissue that is specific to ENS patients and may serve as a reliable radiographic and endoscopic finding in diagnosis.
4 Laryngoscope, 134:1089-1095, 2024.