컴퓨터단층촬영을 이용한 비중격 만곡증 환자의 안와벽 결손 유병률에 대한 연구
A Study on the Incidence of Orbital Wall Defects in Patients with Nasal Septal Deviation Using Computed Tomography
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Background and Objectives: The orbit contains important structures such as the eyeball, optic nerve, and extra- ocular muscles. A defect the orbital wall is a clinically important anatomical variation because it can cause serious complications during nasal surgery. The authors investigated the incidence of orbital defects in patients of chronic sinusitis with nasal septal deviation and found out whether there is a relationship between chronic sinusitis and orbital defects to help the surgical treatment of these patients. Materials and Methods: The computed tomography (CT) and medical records of 247 patients with chronic sinusitis with septal deviation (study group) and 470 patients with septal deviation only (control group) were analyzed retrospectively. The average age of patients was 34.05 years for males and 33.67 years for females. Results: The incidence of orbital defects was statistically higher with 22 out of 247 subjects in the study group (8.9%) than 22 out of 470 subjects in the control group (4.7%)(Chi-square verification result, significance level 0.05). In both groups, the direction and degree of nasal septal deviation did not significantly affect the incidence of orbital defects, and medial orbital defects were the most common in both groups (study group, 90.9%, 20/22, control group, 86.4%, 19/22). Conclusions: About 9% of patients with chronic sinusitis with septal deviation showed defects of the orbital wall, which is easy to be damaged in sinus surgery and can lead to permanent complications. We should prevent such complications through evaluating CT and detailed medical history of the patient before surgery.
Abstract
Background and Objectives: The orbit contains important structures such as the eyeball, optic nerve, and extra- ocular muscles. A defect the orbital wall is a clinically important anatomical variation because it can cause serious complications during nasal surgery. The authors investigated the incidence of orbital defects in patients of chronic sinusitis with nasal septal deviation and found out whether there is a relationship between chronic sinusitis and orbital defects to help the surgical treatment of these patients. Materials and Methods: The computed tomography (CT) and medical records of 247 patients with chronic sinusitis with septal deviation (study group) and 470 patients with septal deviation only (control group) were analyzed retrospectively. The average age of patients was 34.05 years for males and 33.67 years for females. Results: The incidence of orbital defects was statistically higher with 22 out of 247 subjects in the study group (8.9%) than 22 out of 470 subjects in the control group (4.7%)(Chi-square verification result, significance level 0.05). In both groups, the direction and degree of nasal septal deviation did not significantly affect the incidence of orbital defects, and medial orbital defects were the most common in both groups (study group, 90.9%, 20/22, control group, 86.4%, 19/22). Conclusions: About 9% of patients with chronic sinusitis with septal deviation showed defects of the orbital wall, which is easy to be damaged in sinus surgery and can lead to permanent complications. We should prevent such complications through evaluating CT and detailed medical history of the patient before surgery.
참고문헌 (19)
- Wu H, "Long-term therapeutic outcome of ophthalmic complications following endoscopic sinus surgery", Medicine, 95(38), pp.e4896~ (2016)
- Bleier BS, "Prevention and management of medial rectus injury", Otolaryngol Clin North Am, 43(4), pp.801~807 (2010)
- Shere JL, "An analysis of 3599 midfacial and 1141 orbital blowout fractures among 4426 United States Army Soldiers, 1980–2000", Otolaryngol Head Neck Surg, 130(2), pp.164~170 (2004)
- Stankiewicz JA, "Complications in endoscopic sinus surgery for chronic rhinosinusitis : a 25-year experience", Laryngoscope, 121(12), pp.2684~2701 (2011)
- Chou TW, "Multiple analyses of factors related to complications in endoscopic sinus surgery", J Chin Med Assoc, 79(2), pp.88~92 (2016)
- Worden CP, "Modeling microdebrider-mediated ophthalmic damage : a word of caution in endoscopic sinus surgery", Rhinol Online, 2, pp.44~49 (2019)
- Kitaguchi Y, "Characteristics of dehiscence of lamina papyracea found on computed tomography before orbital and endoscopic endonasal surgeries", J Craniofac Surg, 27(7), pp.e662~5 (2016)
- Moulin G, "Dehiscence of the lamina papyracea of the ethmoid bone : CT findings", Am J Neuroradiol, 15(1), pp.151~153 (1994)
- Han MH, "Nontraumatic prolapse of the orbital contents into the ethmoid sinus : evaluation with screening sinus CT", Am J Otolaryngol, 17(3), pp.184~189 (1996)
- Meyers RM, "Interpretation of anatomic variations of computed tomography scans of the sinuses : a surgeon’s perpective", Laryngoscope, 108(3), pp.422~425 (1998)
- Abe K, "CT evaluation of medial protrusion of the lamina papyracea", Jibi Inkoka Rinsho, 96(3), pp.225~230 (2003)
- Stankiewicz JA, "Complications in endoscopic intranasal ethmoidectomy : an update", Laryngoscope, 99(7), pp.686~690 (1989)
- Stankiewicz JA, "Blindness and intranasal endoscopic ethmoidectomy : prevention and management", Otolaryngol Head Neck Surg, 101(3), pp.320~329 (1989)
- Freedman HM, "Complications of intranasal ethmoidectomy : a review of 1, 000 consecutive operations", Laryngoscope, 89(3), pp.421~434 (1979)
- "KCDC", 2011
- Seo SH, "Clinical rhinology", pp.263~280, Iljokak
- Lawrence R, "Pediatric septoplasy : a review of the literature", Int J Pediatr Otorhinolaryngol, 76(8), pp.1078~1081 (2012)
- Mladina R, "The role of maxillar morphology in the development of pathological septal deformities", Rhinology, 25(3), pp.199~205 (1987)
- Valencia MR, "Radiological findings of orbital blowout fractures : a review", Orbit, 40(2), pp.98~109 (2021)
