전산화단층촬영의 분석을 통한 비부비동 내시경 재수술에 영향을 미친 해부학적 구조 및 비정상적 소견

Abstract

Background and Objectives The aim of this study was to evaluate the non-dissected anatomic structures and abnormal computed tomographic findings that contribute to the recurrence of chronic rhinosinusitis (CRS) or the trail of revision endoscopic sinus surgery (ESS). Subjects and Method The medical records of 34 subjects who were diagnosed with recurrent chronic rhinosinusitis, and required to undergo revision endoscopic sinus surgery were collected retrospectively. The subjects’ computed tomography results were examined by a radiology specialist. Results The most common anatomic factors associated with the revision ESS for recurrence of CRS or retained inflammation were residual uncinate process (47.0%) and residual anterior ethmoidal cells followed by undissected posterior ethmoidal cells (38.2%) and obstructed sphenoid sinus ostium (32.3%). In addition, the uncorrected septal deviation, retained agger nasi cells or Haller cells and lateralized middle turbinate were also identified in the patients. Conclusion From these data, we analyzed anatomical structures and CT findings related to the failure of primary ESS. We suggest that careful attention be given to these structures after primary ESS so as to reduce the failure rate and increase successful outcomes.