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经蝶进路的影像解剖学研究 |
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廖建春 范静平 叶青 王海青 吴建
陈菊祥 肖璧君 彭玉成 赵舒微 郎军添 孙爱华
【摘要】目的：为经蝶进路手术提供影像解剖学资料。方法：对50具成人头颅冠状位、矢状位及水平位薄层CT扫描。观测鞍区手术最常用的二种进路经鼻外筛窦蝶窦时路及经鼻中隔蝶窦进路的相关影像解剖。结果：前鼻棘至蝶窦前壁的平均距离：左侧：56.5±5.9mm；右侧：54.9±7.2mm；鼻根点至蝶窦前壁的平均距离：左侧：44.3±5.6mm；右侧：44.0±6.5mm；前鼻棘至鞍底中点的平均距离：左侧：74.5±6.4mm；右侧：73.8±6.8mm；鼻根点至鞍底中点的平均距离：左侧：60.9±7.2mm；右侧：60.2±7.8mm。二进路的解剖距离相差12～14mm。结论：CT影像解剖测量对选择不同的手术进路更具实际的指导意义。
【关键词】经蝶进路 影像解剖 CT扫描
Imaging anatomy study on the transnasal sphenoid appraoch
Liao Jianchun,Fan Jingping,Ye Qing,et al.
Department of Otolaryngology,Changzheng Hospital of the Second Military Medical University,Shanghai 200003
Objective:To provide imaging anatomy basis for the transnasal sphenoid approach.Methods:50 adult head specimens were studied through thinner CT scanning with coronal,sagittal,axial position.The most two common used approach of saddle area operation (extemal ethmoid approach and transnasal sphenoid approach) was observed.Results:The distance from the front wall of sphenoid sinus to the nasal spine was 56.5±5.9 mm for left and 54.9±7.2 mm,44.3±6.5 ,,for left and 44.0±6.5 mm for right to nasion.The average distance from middle point of sphenoid saddle bottom to nasal spine was 74.5±6.4 mm for left and 73.8±6.8 mm for right,60.9±7.2 mm and 60.2±7.8 mm to nasion.There was 12-14 mm anatomy distance between the external ethmoid approach and transnasal sphenoid approach.Conclusion: These imaging anatomy measured with CT was instructive significance to chose the operation approach.
Key words:Transnasal sphenoid approach Imaging anatomy CT scanning
随着经鼻蝶窦垂体瘤切除术及内窥镜鼻窦外科的广泛开展，对经鼻蝶窦进路的应用解剖学研究也报告不少，我们在实践中体会到从CT扫描片中观测经蝶进路的相关解剖对临床手术更具实际指导意义。为此，我们采用多方位CT扫描进行经蝶进路的影像解剖学观测，现报告如下：
1 材料和方法
1.1 材料 50具(男性29，女性21)经防腐处理过的完整成年头部标本，均无畸形及外伤改变，鼻窦内无肿瘤、新生物及明显的炎症病变。
CT扫描条件：所用CT机为SE[1] [2] 下一页
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