鼻中隔胚胎发育及偏曲的组织学观察及其临床意义

Histological observation and clinical significance of the embryonic development and deviation of fetal nasal septum

目的：为探讨鼻中隔偏曲的原因以及为临床鼻科医生对先天性鼻中隔偏曲的早期检查和矫正提供组织形态学依据。方法：观察８２例１２～４０ｗ胎儿鼻中隔发育的组织形态学特点。结果：①先天性鼻中隔偏曲发生率为３３％，其偏曲程度较轻，主要位于鼻中隔的垂直板中央区和垂直板与犁骨交界处；②筛骨垂直板的上下径生长大于犁骨，且骨化时间晚，至出生时仍未骨化；③筛骨垂直板中央区为鼻中隔最薄处；④犁骨沟呈“Ｕ”形，宽而深。结论：①鼻中隔偏曲在母体内即可发生，且主要发生在鼻中隔中部，而前部易受后天性损伤而致偏曲；②筛骨垂直板与犁骨之间的生长不平衡是导致先天性鼻中隔偏曲的重要原因，即为主动性偏曲。

objective:To provide the histo-morphological data for clinical examination and correction of congenital nasal septum deviation in newborns infants.Methods:The histology and morphologic characters of the nasal septum were observed on 82 fetuses from the age 12～40 weeks.Results:The incidence ratio of the congenital septal deviation was 33%.Most of them had a slight degree ,which occurred at the central portion of the perpendicular plate and the junction of the perpendicular plate and the vomer.The perpendicular plate grows faster than vomer along the superior-inferior axis and does not ossify until birth.The central portion of the perpendicular plate was the thinnest portion of the nasal septum.The wide deep vomerine groove showed a'U'type in shape.Conclusions:The nasal septum deviation at the central part could be happened in the intrauterine life,but most of the deviation at the anterior nasal septum was caused by acquired trauma.The primary reason to cause the congenital septum deviation was the disequilibrium growth between the perpendicular plate and the vomer.