CT泪囊造影术及三维重建在鼻腔结构异常伴功能性溢泪诊治中的应用  

CT-DCG and 3D reconstruction in treatment and diagnosis of patients with nasal structural abnormality accompanied by asymptomatic lacrimal flow

作　　者：唐海红[1] 孙广滨[2] 刘锋[1] 郑宏良[1] 李兆基[1] 张速勤[1] 

机构地区：[1]第二军医大学长海医院耳鼻咽喉科,上海200433 [2]上海市浦东新区公利医院耳鼻咽喉科,上海200135

出　　处：《第二军医大学学报》2011年第6期650-653,共4页Academic Journal of Second Military Medical University

基　　金：上海市科委科研计划项目(034119831);第二军医大学青年基金~~

摘　　要：目的探讨CT泪囊造影术(computed tomographic dacryocystography,CT-DCG)和泪道系统的CT三维重建(CTthree-dimensional reconstruction)在诊治鼻腔结构异常伴功能性溢泪中的应用价值。方法鼻腔结构异常并伴功能性溢泪及鼻阻塞患者18例,均有下鼻甲肥大,其中12例同时伴有鼻中隔偏曲。术前均排除由眼部疾病引起的溢泪。所有患者均采用CT-DCG和三维重建检查,行鼻内镜下鼻甲低温等离子射频消融术,12例伴鼻中隔偏曲者同时行鼻中隔偏曲矫正术,观察疗效。术后随访12个月。结果 CT-DCG和CT三维重建术能清晰显示泪道引流系统的解剖形态及其与周围组织的关系,术前影像显示鼻泪管口通而不畅,术后影像显示泪道系统通畅,造影剂可顺利经下鼻道流出。18例患者术后鼻中隔均居中,下鼻甲明显缩小。其中鼻阻塞痊愈14例(77.8%),好转4例(22.2%);13例(72.2%)溢泪症状消失,5例(27.8%)溢泪症状好转。结论 CT-DCG和泪道系统的三维重建技术对鼻腔结构异常伴功能性溢泪的诊治具有较大的临床应用价值。Objective To explore the value of computed tomographic dacryocystography （CT-DCG）and computed tomographic three-dimensional（ 3D） reconstruction in diagnosis and treatment of patients with nasal structural abnormality accompanied by asymptomatic lacrimal flow. Methods A total of 18 nasal structural abnormality patients with asymptomatic lacrimal flow and nasal obstruction were enrolled in the present study. All the 18 cases had hypertrophic inferior turbinate and 12 cases also had nasal septum deviation. The lacrimal flow caused by ocular diseases was excluded. All the patients received radiofrequency ablation of the inferior turbinate under nasal endoscope, and the 12 patients also received nasal septum deviation surgery. The CT-DCG and 3D reconstruction were done preoperatively and postoperatively. All the patients were followed up for 12 months. Results CT-DCG and 3D reconstruction could clearly display the anatomy of lacrimal duct and the surrounding tissues. Preoperative image showed obstruction of orifice of the nasolacrimal duct; postoperative image showed patent lacrimal duct and the contrast medium could flow out from the nasal passage. All the 18 cases had the nasal septum at the middle line, with shrunk inferior turbinate. The nasal obstruction recovered in 14（77.8%） patients and improved in 4（22. 2%） patients. The symptom of epiphora disappeared in 13 （72. 2%） and improved in 5 cases （27. 8%）. Conclusion CT-DCG and 3D reconstruction of lacrimal duct is valuable for clinical management of patients with nasal structural abnormality accompanied by asymptomatic lacrimal flow.

关 键 词：CT泪囊造影术 三维重建 下鼻甲肥大 鼻中隔偏曲 功能性溢泪 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]