Radiographic Variants Associated With Allergic Fungal Rhinosinusitis: Key Differences for Pre-Operative Planning.

IF 1.3 4区医学 Q3 OTORHINOLARYNGOLOGY Annals of Otology Rhinology and Laryngology Pub Date : 2024-10-29 DOI:10.1177/00034894241293390

Dylan Z Erwin, Matthew Y Liu, Mason R Krysinski, Alexander M Choi, Bundhit Tantiwongkosi, Philip G Chen

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Abstract

Objectives: Allergic fungal rhinosinusitis (AFRS) often results in expansion of disease beyond the paranasal sinuses, which may put important structures, such as the anterior ethmoid artery (AEA) or lateral lamella of the cribiform, at risk of injury during endoscopic sinus surgery (ESS). This study aims to compare the AEA to skull base (AEA-SB) length in patients with AFRS versus chronic rhinosinusitis with nasal polyps (CRSwNP), as well as additional anatomic variants.

Methods: A single institutional retrospective chart review of patients undergoing ESS for AFRS and CRSwNP was performed. AEA-SB length were compared between the 2 groups. Other anatomic variants, including Keros measurement and presence of supraorbital ethmoid air cells (SOEC), concha bullosa (CB), sphenoethmoidal, and infraorbital ethmoid cells were measured and compared between the 2 groups.

Results: Twenty-one patients were included in each cohort. The AFRS group was younger in age (P = .015) and had a significantly longer AEA-SB length (P = .014) compared to the CRSwNP group. No significant differences were observed between the 2 groups regarding Keros measurement, presence of concha bullosa, infraorbital ethmoid, sphenoethmoidal, or SOEC. No association was seen between AEA-SB length and Keros class in either group.

Conclusions: AFRS harbors anatomical differences when compared to CRSwNP, with the former associated with a longer AEA-SB length. This key difference should be considered in preoperative planning to prevent injury to the AEA in patients undergoing ESS for AFRS.

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与过敏性真菌性鼻炎相关的放射学变异：术前规划的关键差异。

目的：过敏性真菌性鼻炎（AFRS）通常会导致疾病扩展到副鼻窦以外的部位，这可能会使乙状前动脉（AEA）或蝶窦外侧薄片等重要结构在内窥镜鼻窦手术（ESS）中面临损伤风险。本研究旨在比较 AFRS 与慢性鼻炎伴鼻息肉（CRSwNP）患者的 AEA 与颅底（AEA-SB）长度以及其他解剖变异：方法：对接受ESS治疗的AFRS和CRSwNP患者进行单一机构回顾性病历审查。比较了两组患者的 AEA-SB 长度。测量并比较两组患者的其他解剖变异，包括 Keros 测量和是否存在眶上乙状气室（SOEC）、牛皮环（CB）、蝶窦和眶下乙状气室：结果：两组各有 21 名患者。与 CRSwNP 组相比，AFRS 组年龄更小（P = .015），AEA-SB 长度更长（P = .014）。两组在 Keros 测量、是否存在大疱性结节、眶下乙状体、蝶状体或 SOEC 方面没有明显差异。两组的AEA-SB长度与Keros等级均无关联：结论：与 CRSwNP 相比，AFRS 存在解剖学差异，前者的 AEA-SB 长度更长。在术前规划时应考虑到这一关键差异，以防止因 AFRS 而接受 ESS 的患者的 AEA 受到损伤。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Otology Rhinology and Laryngology 医学-耳鼻喉科学

CiteScore

3.10

自引率

7.10%

发文量

171

审稿时长

4-8 weeks

期刊介绍： The Annals of Otology, Rhinology & Laryngology publishes original manuscripts of clinical and research importance in otolaryngology–head and neck medicine and surgery, otology, neurotology, bronchoesophagology, laryngology, rhinology, head and neck oncology and surgery, plastic and reconstructive surgery, pediatric otolaryngology, audiology, and speech pathology. In-depth studies (supplements), papers of historical interest, and reviews of computer software and applications in otolaryngology are also published, as well as imaging, pathology, and clinicopathology studies, book reviews, and letters to the editor. AOR is the official journal of the American Broncho-Esophagological Association.