上颌窦口扩大手术中鼻后外侧动脉的保护

The protection of posterior lateral nasal arteries during the enlargement operation of apertura maxillaris

目的:探讨鼻后外侧动脉在鼻内镜上颌窦口扩大手术中的影响以及鼻后外侧动脉的保护。方法:应用10具(20侧)10%福尔马林防腐固定乳胶灌注之成人头部标本,观察中鼻道结构,解剖鼻后外侧动脉及其分支,观察鼻后外侧动脉的走行与分布,并测量其外径。观察鼻后外侧动脉与上颌窦口扩大手术的关系。结果:鼻后外侧动脉在蝶腭孔处分出蝶腭动脉,向前下走行,在中鼻甲后端分出中鼻甲动脉,下鼻甲动脉,少数有上鼻甲动脉分支。鼻后外侧动脉外径(1.02±0.07)mm,中鼻甲动脉外径(0.89±0.06)mm,下鼻甲动脉外径(0.94±0.07)mm。鼻后外侧动脉下鼻甲分支在中鼻道的中点,在中鼻甲后端前方的距离(10.35±2.06)mm。结论:开放上颌窦开口时,在距离中鼻甲后端保留1～1.5cm的距离,可以避免鼻后外侧动脉损伤,如果必须扩大要应用电凝彻底止血。

Objectives：To investigate the influence of the enlargement operation of apertura maxillaris on the lateral nasal arteries and discuss the protection of the lateral nasal arteries during the operation. Methods： 10 cases （20 sides） lactoprene infused and fixed adult heads were used to dissect the lateral nasal artery and observe its relationship with apertura maxillaris. RetailS.The posterior lateral nasal arteries usually arised fi＇om the sphenopalatine artery in the sphenopalatine foramen, and coursed antero-inferiorly. The branches of it supplied the middle and inferior turbinates. The external diameters of the posterior lateral nasal arteries, the middle turbinate arteries and the inferior turbinate arteries were （1.02±0.07）mm, （0.89±0.06） mm, and （0.94±0.07） mm respectively. During the middle nasal meatus, the inferior turbinate arteries was anterior to the posterior extremity of the middle turbinate （10.35 ±2.06） mm. Conclusions： During the enlargement operation of apertura maxillaris, the distance between the posterior margin of the incisal opening and the posterior extremity of the middle turbinate should be remained about 1 to 1.5 cm, thus the injury of the inferior turbinate arteries can be avoided.