| Objective: To analysis osteitis signs occurrence rate, types, characteristics and their respective sense by studying the preoperative CT scan images of primary sinonasal inverted papilloma.Assess if it is possible to predict the attachment site of SIP by looking for signs of osteitis on CT scan images, in order that Otolaryngologists could make the right Surgical Strategy preoperatively, remove the tumor completely by accurately positioning the attachment site of the tumor Intraoperatively, and finally reduce the recurrence Postoperatively.Methods: The cases was gathered,which conformed to the diagnostic criteria of SIP in the first hospital affiliated to Dalian Medical University from December2000-January 2015. The equipment used for CT scanning is the Siemens 16-slice spiral CT from the First Affiliated Hospital of Dalian Medical University, Department of Radiology. All CT scan images blong to the 45 cases was analyzed by using the UNISIGHT TeamView software. The main discussion is the features of osteitis signs on the CT and its clinical significance.We also care about the relationship between the site of osteitis signs and where SIP attachment site. Use the SPSS software to do the statistical analysis for all the result data.Results:1. Amony the 45 cases, 38 patients with osteitis, osteitis positive rate is 84.44%; 35 patients with osteoarthritis(77.78%), the patients with bone destruction are 28 cases(62.22%),with new bone formation are 3 cases(6.67%).2.Amony the 10 cases which with only one Osteitis sign, of 8 cases the position of osteitis sign are just the where the tumor attachments are. Coincidence rate of 80.00%.The remaining 28 cases all have multiple osteitis sign.3. The actual location of the tumor most commonly attached to the lateral nasal wall in 20 cases(44.44%), followed by 13 cases of maxillary sinus(28.89%), again ethmoid nine cases(20.00%), frontal, sphenoid sinus and orbital cardboard each one patients(2.22%), nasal septum with no attached. The attachment site of the tumor was located in a separate anatomical location, and no multiple attachment. Osteitis sites total 68,compliance rate of 39.71%. From the position of the distribution of osteitis view: up occurred in the lateral nasal wall(42.65%), followed by the maxillary sinus(27.94%),again ethmoid sinus(17.64%), frontal sinus and sphenoid sinus relatively rare(4.41%),occasionally occur in the orbital cardboard and nasal septum(1.47%).4.Divided the locations of Osteitis into two groups: A.lateral nasal wall and maxillary sinus area; B ethmoid sinus, frontal sinus, sphenoid sinus, orbital cardboard and nasal septum. Compare the ompliance rate between group A with group B,X2 test showed that the site of attachment osteitis and SIP compliance rate have no significant difference between the two groups.5. Bone thinning, damage absorption, absence of 32(47.06%); bone sclerosis 36(52.94%), which diffuse hyperostosis 8(11.76%), focal hyperosteogeny 28(41.18%);new bone formation 3(4.41%). 27 osteitis point have the same location with SIP attachment site,Among which 26 are focal osteoarthritis,the other one is bone thinning,no diffuse hyperostosis.6. Involving 43 patients with unilateral tumor(95.56%), which left 22 cases, 21 cases on the right side; two cases involving the bilateral(4.45%). 32 cases involving the nasal cavity tumor shadow(71.11%), maxillary sinus 25 cases(55.56%), ethmoid sinus 17cases(37.78%), 10 cases of sphenoid sinus(22.22%), 6 cases of nasopharyngeal(13.33%), forehead sinus 5 cases(11.11%);Involving the ipsilateral orbit and orbital tissues one case(2.22%), merge sinus cyst for four cases(8.89%). Cases of "bubble" sign for 29 cases(64.44%). Natural orifice expansion signs 29 cases(64.44%). The CT number of SIP tumors shadow showed the highest 78 HU, lowest 20 HU. Sample mean for 40.39 HU, the sample standard deviation for 10.88 HU, this group of tumors shadow in CT number of about 40.39±10.88 HU.Conclusions:1. Preoperative CT shown the highest incidence of signs of Hyperostosis in the sinonasal inverted papilloma,so it is the most common type bone changes.2. The location of hyperosteogeny were the most consistent with the tumor attachment position in primary sinonasal inverted papilloma; Focal Hyperostosis ia a specific signal for SIP attachment site.Looking for the position of Hyperostosis in preoperative CT, especially the focal Hyperostosis, could predict the attachment site of the primary sinonasal inverted papilloma effectively.3. When the separate existence signs of osteitis occurs in the preoperative CT scan images, it is highly correlated with the attachment site of the sinonasal inverted papilloma.4. The accuracy of the forecast for the SIP attachment site made by looking for the Osteitis signs have no significant correlation with the Anatomical location. |
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