| 1 DEPARTMENT OF OTORHINOLARYNGOLOGY-HEAD AND NECK SURGERY, SEOUL NATIONAL UNIVERSITY HOSPITAL, SEOUL, KOREA 2 DEPARTMENT OF OTORHINOLARYNGOLOGY-HEAD AND NECK SURGERY, SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL, SEOUL, KOREA 3 SENSORY ORGAN RESEARCH INSTITUTE, MEDICAL RESEARCH CENTER, SEOUL NATIONAL UNIVERSITY 4 INSTITUTE OF ALLERGY AND CLINICAL IMMUNOLOGY, MEDICAL RESEARCH CENTER, SEOUL NATIONAL UNIVERSITY 5 DEPARTMENT OF OTORHINOLARYNGOLOGY-HEAD AND NECK SURGERY, SARAWAK GENERAL HOSPITAL, SARAWAK, MALAYSIA |
목적: We investigate factors affecting sphenoid sinus volume(SSV),its pneumatization type and its
relation to isolated fungal sphenoid sinusitis(IFSS). 방법:A total of 47patients(20males,27females) with a mean age of 66.6years(ranging 40-84 years)
with pathologically diagnosed IFSS between October 2021-December 2023 were included in this
study.Parameters studied include presence of Onodi cells(OC),anterior clinoid
pneumatization(ACP),lateral recess pneumatization(LRP),obstruction of pathway to SS and types
of SS pneumatization. The SSV of the pathological and normal sides of the patients were
compared.
결과:Majority of subjects presented with sellar type pneumatization 44,followed by postsellar
21,presellar 17 and conchal 12.LRP and ACP presented in 62.8% and 18.1% of SS,respectively
while 37.2% of subjects had presence of OC.12.8% showed airway passage obstruction by either
superior turbinate or middle turbinate touching the septum.
The minimum SSV is 0.69cm2 and the maximum is 16.8cm2 while the mean volume averages
5.33cm2 + 3.18.Presence of ACP and OC does not significantly affect
SSV(UACP=506,n1=77,n2=17,p=0.146, UOC=877,n1=59,n2=35,p=0.225).Presence of LRP
significantly increases SSV(ULRP=521,n1=35,n2=59,p<0.05, with a large effect size
r=0.41).There was no significant difference in SSV between genders(UMF=849,n1=40,n2=50,
p=0.077) nor when compared uninfected SS versus IFSS(UV=1090,n1=44,n2= 50,p=0.94).
Chi-square statistics were used to examine the association between gender,ACP,LRP and
presence of OC in relation to incidence of IFSS.There is no significant association found at 5%
significance level(xMF2= 0.013, df=1, p=0.908, xACP2=1.105,df=1,p=0.293,
xLRP2=1.038,df=1,p=0.308, xOC2=1.252,df=1,p=0.263). However, when the passage to the
sphenoid sinus is obstructed,it significantly increased the incidence of
IFSS(xOB2=8.179,df=1,p=0.04 Fishers Exact test p=0.05 with a medium effect size r= 0.295 결론:Presence of LRP can significantly increase SSV. There is no significant correlation between SSV
and the incidence of IFSS. Anatomical obstruction of airway passages to the sphenoid sinus,
contributes to an increased incidence of IFSS.
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