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后筛窦的影像解剖学研究 |
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廖建春 郎军添 王海青 范静平 吴建 陈菊祥 吕春雷 叶青 彭玉成 赵舒微
【摘要】目的：为了提供对内窥镜鼻窦外科及颅底外科手术更具指导意义的后筛窦影像解剖资料。方法：取50具成人头颅标本，行冠状位、矢状位及水平位薄层CT扫，从不同层面及不同方位观测后筛的气化发育情况。结果：发现属管前型的占23%(23侧)；半管型的占28%(28侧)；全管型的占33%(33侧)；蝶鞍型的占16%(16侧)。其中两侧气化分型完全相同者占33例(66侧)；两侧气化不相同者占17例(34侧)。发现属Ⅰ°后筛窦的占43%(43侧)；属Ⅱ°后筛窦的占35%(35侧)，其中属Ⅱa°后筛窦的占19%(19侧)，属Ⅱb°后筛窦的占16%(16侧)；属Ⅲ°后筛窦的占22%(22侧)。其中两侧分度完全相同者占29例(58侧)；两侧分度不相同者占21例(42侧)。结论：后筛窦影像解剖分型分度对内窥镜鼻窦外科及颅底外科手术具有实际的指导意义。
【关键词】后筛窦 影像解剖 CT扫描
Imaging anatomy study of the posterior ethmoid sinus
Liao Jianchun,Lang Juntian,Wang Hiqing,et al.
Department of Otolaryngology,Changzheng Hospital of the Second Military Medical University,Shanghai 200003
Objective:To provide imaging anatomy basis of the psoterior ethmoid sinus for endoscopic sinus surgery and basicranial surgery.Methods:Coronal,sagittal and axial slice CT scanning was performed on 50 adult head specimens to observe the pneumatization and development of the posterior ethmoid sinus on different slices and drections.Results:According to its appearance,the posterior ethmoid sinus could be divided into four types such as pre-canal type which accounted for,half-canal type was 23% (23 sides),28%,33% and 16% respectively.In 33 cases,the pneumatizzation and classification of both sides were identical,while the other 17 cases were non-identical.Moreover,the pneumatization of 43% posterior ethmoid sinus was to degree Ⅰ，35% was degree Ⅱa, 19% was degree Ⅱb and 22% was degree Ⅲ.Identical pneumatizations of both sides posterior ethmoid sinus were found in 29 cases.The other 21 cases was non-identical pneumatization Conclusions:These imaging anatomy data should be instructive significance for ehdoscopic sinus surgery and basicranial surgery.
Key words:Posterior ethmoid sinus Imaging anatomy CT scanning
随着内窥镜鼻窦外科、鼻神经显微外科及颅底外科的深入开展，对造成蝶筛区严重手术并发症如失明、脑脊液鼻漏及颅内大出血等的解剖学原因逐渐被临床鼻科学者和临床解剖学者所认识。后筛窦及其毗邻解剖区域是鼻窦手术危险的区域，对这一区域一解剖研究在国内外[1] [2] 下一页
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