蝶窦开口的术中观察及其意义

Observations On Sphenoid Sinus' Openings During Operation and Its Significance

目的:介绍根据蝶窦开口位置指导术中鞍底凿开的方法。方法:总结77例经蝶手术中所见蝶窦开口及周围结构特点。结果:77例蝶窦开口位置均位于筛骨垂直板之上,蝶嵴的两侧偏上;蝶窦口的形态以椭圆形居多,少部分为条状裂隙;蝶窦气化良好者,窦口偏大,长条形为主,两侧构成八字形;蝶窦口处即为蝶窦腹侧壁。结论:术中找见蝶窦口视作蝶窦凿开处进入蝶窦较为安全;以窦口上缘为标记,于其下2～3mm的鞍底隆突为鞍底凿开处,凿开范围则不超过蝶窦口上缘。

Objective: To introduce a method of boring sellar base according to the position of sphenoid sinus' opening. Methods: The apperatus of sphenoid sinus in 77 cases dserved during operation were summeriaed. Results :The sphenoid sinus openings of all patients are above the upper part of vertical plate of ethmoid bone, beside the sphenoidal creat. The openings of most sphenoid sinus are oval in shape. Some are split (crevice) . They are larger when their gasification are well enough. The pattern 'A' are formed by openings of two sides . Conclusion: The opening of sphenoid sinus should be used as mark of mortising through sphenoid sinus, then to the sellar base of the corresponding site, but not beyond the upper margin of the opening.