胎儿鼻甲发育和鼻腔阔度的观测及临床意义

Observation and Clinical Significance of Embryonic Development of the Conchae and Width of the Nasal Cavity in Fetus

目的探讨胎儿鼻甲与鼻腔发育的形态学特点，为胚胎发育提供资料。方法对１０６例１２～４０周胎儿的游离鼻腔标本，采用石蜡包埋切片，ＨＥ染色，光镜观测。结果（１）胚胎早期，鼻甲以软组织结构由鼻腔外侧壁向内隆起，其最上鼻甲出现率为７６．０８％。（２）各鼻甲骨化过程均由鼻腔外侧壁的骨质沿其附着板向鼻甲内延伸扩展。至出生时，鼻甲内的骨质细而疏松，部分骨质出现“海绵状”结构，而未见异常的中鼻甲气化。（３）中、下鼻甲的游离缘粘膜呈“锤样”膨大，其固有层内含丰富的血管和腺体。（４）鼻腔的平均宽高指数随胎龄增长而减小（Ｐ＜０．０５），各鼻道的前部较后部狭窄。结论胎儿鼻甲相对较大，而各鼻道则狭小，鼻甲内骨质薄而细，鼻腔的上下径增长速度大于横径的增长。

Objective\ The morphological features of the nasal conchae and cavity were investigated in fetus to provide the data for the embryonic development.\ Methods\ 106 specimens ranging from 12～40 weeks of a embryonic age were cut into serial sections,stained with hematoxylin and eosin,observed by histological method.\ Results\ The nasal conchae,composing of the softtissue,bulged from the lateral wall of the nasal cavity at the early fetal age. The presence of the supreme concha was 76.08%. Each concha was ossified at its attachment lamina from the lateral wall of the nasal cavity. The bonytissue of the conchae was thin loose and spongy. Abnormal pneumatization of the middle concha,or concha bullosa was not found in specimens. The mucosa in the free edge of the middle and inferior conchae was expanded and“hammer” in shape. The tunica propria was more and glandular. The average index of the width/height of the nasal cavity decreases with increasing of fetal age(P< 0.05). \ The anterior part of the concha meatuses was narrower than the posterior part of them.\ Conclusion\ The nasal conchae,whose bonytissue was thin,were relatively large,and the nasal meatuses were narrow in fetus. Growth of the nasal cavity in longitudinal axis was more rapid than it in transverse axis with increasing of fetal age.