上颌窦后鼻孔息肉：鼻腔解剖和病理变异作为危险因素

文献信息

中文摘要

引言： 上颌窦后鼻孔息肉的病因发病机制仍存在争议。
目的： 了解上颌窦后鼻孔息肉的发生发展，并评估其形成的解剖和病理危险因素。
方法： 本研究纳入40名上颌窦后鼻孔息肉患者作为研究组，以及40名单侧上颌窦炎患者作为对照组。我们比较了两组在病理变异方面的差异，包括对侧上颌窦黏膜增厚和窦腔囊肿的存在。我们还比较了两组在解剖变异方面的差异，如鼻中隔偏曲、副上颌窦口、中鼻甲气化、反常中鼻甲以及钩突附着方式。
结果： 在对侧上颌窦中发现窦腔囊肿在上颌窦后鼻孔息肉患者中显著比单侧上颌窦炎患者更常见。此外，鼻中隔向病变对侧偏曲在上颌窦后鼻孔息肉组中显著比单侧上颌窦炎组更常见。
结论： 上颌窦后鼻孔息肉被认为起源于上颌窦内的窦腔囊肿，由于上颌窦和鼻腔内的压力变化而延伸至鼻腔。鼻中隔向受累上颌窦对侧偏曲所引起的鼻腔气流变化，可能是既存窦腔囊肿形成上颌窦后鼻孔息肉的重要危险因素。

英文摘要

INTRODUCTION: The etiopathogenesis of antrochoanal polyp remans debatable.
OBJECTIVES: To understand antrochoanal polyp development and to assess anatomical and pathological risk factors for its formation.
METHODS: This study included 40 subjects with antrochoanal polyp as a study group and a control group of 40 subjects with unilateral maxillary sinusitis. We compared the groups with respect to pathologic variants including the presence of thickened mucosal lining and antral cyst in the contralateral maxillary sinus. We also compared groups regarding anatomic variants such as nasal septal deviation, accessory maxillary sinus ostium, concha bullosa, paradoxical middle turbinate, and uncinate process insertion.
RESULTS: Antral cyst was found in the contralateral maxillary sinus was significantly more prevalent in subjects with antrochoanal polyp than in subjects with unilateral maxillary sinusitis. Additionally, nasal septal deviation toward the opposite side of the pathology was significantly more frequent in antrochoanal polyp group than in unilateral maxillary sinusitis group.
CONCLUSION: Antrochoanal polyp is suggested to originate from an antral cyst in the maxillary sinus, which extends into the nasal cavity due to pressure changes within the maxillary sinus and nasal cavity. Changes in the nasal cavity airflow caused by nasal septal deviation toward the opposite side of the affected maxillary antrum may represent an important risk factor for antrochoanal polyp formation from a pre-existing antral cyst.