KONKA BÜLLOZA ALT TİPLERİ ÜZERİNE GENİŞLETİLMİŞ BİR ÇALIŞMA

Elif Elibol
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Abstract

To determine the concha bullosa subtypes and their possible associations with chronic sinusitis, osteomeatal complex obstruction, mucosal thickening and other sinonasal anatomic variations, in a large group of patients with concha bullosa. This retrospective study was conducted between January 2019 and March 2020 in two different institutions. The paranasal CT sections and medical records of 850 patients (1700 sides) were evaluated, and the association of concha bullosa subtypes with other sinonasal variations like chronic sinusitis, osteometal complex obstruction and mucosal thickening was investigated. Concha bullosa was observed in 430 (25.2%) of 1700 sides. Of 430 bullous conchas, 160 were bilateral (37%), 245 were on the right (56.9%), 185 were on the left (43.1%). Extensive type in 202 sides, bulbous type in 118 sides and lamellar type in 100 sides were observed. A significant association of extensive type concha bullosa with chronic sinusitis (p: 0.025), osteometal complex obstruction (p: 0.043) and septum deviation was found (p: 0.013). Additionally, a significant association of lamellar type concha bullosa with female gender (p: 0.021) and of bulbous type concha bullosa with osteomeatal complex obstruction (p: 0.038) was evident. The most frequent anatomical variation was septal deviation, found in (73.1%) 256 of 350 patients with concha bullosa. The frequency of chronic sinusitis, osteomeatal complex obstruction and septal deviation were significantly higher in extensive type concha bullosa than in the other subtypes. Familiarity of surgeons and radiologists with concha bullosa subtypes might be important for determining the treatment algorithm during endoscopic sinus surgery.
目的:探讨大龟甲患者的大龟甲亚型及其与慢性鼻窦炎、骨窦复合体阻塞、粘膜增厚等鼻窦解剖变异的可能关系。这项回顾性研究于2019年1月至2020年3月在两个不同的机构进行。对850例(1700侧)患者的鼻旁CT切片及病历资料进行分析,探讨甲大疱亚型与慢性鼻窦炎、骨金属复合体梗阻、粘膜增厚等其他鼻窦病变的关系。1700侧中有430例(25.2%)出现大球甲。430例大疱性耳廓中,双侧160例(37%),右侧245例(56.9%),左侧185例(43.1%)。广泛型202面,球茎型118面,板层型100面。广泛型大耳甲与慢性鼻窦炎(p: 0.025)、骨金属复合阻塞(p: 0.043)和鼻中隔偏曲(p: 0.013)有显著相关性。此外,板层型大龟甲与女性有显著的相关性(p: 0.021),球茎型大龟甲与骨臼复合阻塞有显著的相关性(p: 0.038)。最常见的解剖变异是鼻中隔偏曲,在350例甲壳大疱患者中有256例(73.1%)发现。慢性鼻窦炎、骨窦复杂性梗阻和鼻中隔偏曲的发生率在广泛型甲壳大疱中明显高于其他亚型。外科医生和放射科医生对甲壳大疱亚型的熟悉程度可能是确定内窥镜鼻窦手术治疗方案的重要因素。
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