鼻内窥镜手术应用解剖学的研究

Study on Applied Anatomy of Endoscopic Narity-Sinus Surgery

目的：给鼻内窥镜手术提供详细的解剖学数据。方法：测量８０例头颅正中矢状切面标本的鼻腔、鼻窦及有关结构，并进行与鼻内窥镜手术有关的测量。结果：①上颌窦口前缘至鼻泪管后缘的距离为（８．６９±３．５８）ｍｍ；小于上颌窦口后缘至蝶腭孔前缘的距离［（１９．９９±３．２５）ｍｍ］；②泪囊后缘与钩突前下缘很接近，有２３例其距离小于１．０ｍｍ；③蝶腭孔与后组筛窦、上颌窦、蝶窦等鼻窦的相邻骨壁间的距离分别为（２．３９±１．３７）ｍｍ、（３．５０±１．２０）ｍｍ及（３．０３±１．６０）ｍｍ。结论：在施行鼻内窥镜手术时，术者须对其解剖相当熟悉，并随时了解器械伸入术腔的深度和角度。

Objective:To provide detail anatomical data for endoscopic narity-sinus surgery.Method:The dissection of nasal cavity and sinus and other related structures was performed on 80 cases of cadavers.And the anatomical structures relevant to endoscopic narity-sinus surgery were also measured and observed.Results:(1)The distance was (8.69±3.58)mm from the anterior edge of the maxillary ostium to the posterior wall of the nasolacrimal duct,smaller than the distance (19.99±3.25)mm from the posterior edge of the maxillary ostium to the anterior edge of sphenopalatine foramen;(2)The posterior wall of the lacrimal sac was close to the anterior edge of the uncinate process,with the distance smaller than 1.0mm in 23 cases of cadavers;(3)The distances between the sphenopalatine foramen and the adjacent skeletal walls of posterior ethmoid labyrinths,maxillary sinus,sphenoid sinus were (2.39±1.37)mm,(3.50±1.20)mm and (3.03±1.60)mm,respectively.Conclusion:When the endoscopic narity-sinus surgery is operated,the operator must be familiar with anatomy of the areas and know the depth and angle of the instrument into operated cavity at anytime.