Objective: To explore the application value of soft endoscopy and hard endoscopy in the clinical examination of chronic sinus tract wounds with different shapes. Methods: A retrospective observational study was conducted. From January 1 to December 23, 2019, a total of 46 patients with chronic sinus tract wounds, who met the inclusion criteria were admitted to the Wound Healing Center of Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, including 23 males and 23 females, aged 18-81 (48±21) years. On admission, computer tomography (CT) imaging and three-dimensional reconstruction was performed to examine the shapes of wound sinus tract and classify the wounds, and the lengths of wound sinus tract examined by CT imaging (hereinafter referred to as reference lengths) were recorded; the lengths of chronic sinus tract wounds were examined by hard endoscopy and soft endoscopy and measured. The wounds with and without obviously curved sinus tract were classified into curve group and straight group respectively, and the deviation rates between the lengths of wound sinus tract examined by soft endoscopy or hard endoscopy and the reference lengths (hereinafter referred to as deviation rates of lengths) in each group were calculated and compared. The differences between the deviation rates of lengths examined by soft endoscopy and hard endoscopy and the deviation rate of reference lengths (0) in each group were compared. Data were statistically analyzed with paired sample t test and Wilcoxon signed rank sum test. Results: CT imaging and three-dimensional reconstruction showed that there were 4 types of wound sinus tract, including tubular (36/46), lamellar (4/46), club-mallet (4/46), and irregular (2/46). Tubular wounds were further divided into type I (23/36), type L (4/36), and type Y (9/36). Wounds with type I tubular, lamellar, and club-mallet sinus tract were classified into linear group (31/46), while those with type Y tubular, type L tubular, and irregular sinus tract were classified into curve group (15/46). In linear group, the deviation rates of lengths of chronic sinus tract wounds examined by hard endoscopy and soft endoscopy were 0. In curve group, the deviation rate of lengths of chronic sinus tract wounds examined by soft endoscopy was 0 (0, 0.58%), which was significantly lower than 41.18% (31.68%, 48.41%) examined by hard endoscopy, Z=-3.408, P<0.01; the deviation rate of lengths of chronic sinus tract wounds examined by hard endoscopy (40±19)% was significantly higher than the deviation rate of reference lengths (t=8.343, P<0.01), while the deviation rate of the lengths of wound sinus tract examined by soft endoscopy was similar to the deviation rate of reference lengths (Z=-1.342, P>0.05). Conclusions: Compared with hard endoscopy, soft endoscopy can observe the internal characteristics of chronic sinus tract wounds in a wider range in the clinical examination of this kind of wound, especially for the exploration of curved chronic sinus tract wounds. The promotion of this method will be conducive to the diagnosis and treatment of chronic sinus tract wounds.
[Application value of soft endoscopy and hard endoscopy in the clinical examination of chronic sinus tract wounds with different shapes]