青年上颌窦及毗邻结构的影像解剖学研究

YOUTH MAXILLARY SINUS AND ADJACENT STRUCTURE IMAGING AND ANATOMICAL STUDY ABSTRACT

目的：通过上颌窦三维立体重建,进一步研究青年上颌窦的立体形态、位置,为临床种植牙、拔牙及外伤和肿瘤手术提供参考依据,同时也为临床研究及人类学青年数据库积累资料。方法：选择正常志愿者34例（68例）,男、女各17例,年龄在18~22岁之间,平均19.8岁。选取上颌骨无明显器质性病变、上下牙列排列整齐及牙齿完整无缺者。实验方法：受试者取仰卧位,以听眦线（OML）为基线,自眶下缘平行扫描至上下颌牙咬合面。利用牙科应Dentalscan行三维重建并测量相关参数。结果：眶下孔最大孔径3.89±1.27mm,眶下管下壁厚度为0.30±0.48mm,眶下孔形态分型：横椭圆形占76.5%（52例）、圆形占23.5%（16例）,其中有副孔者占1.5%（1例）,其余均为单孔;尖牙窝壁厚1.10±0.40mm;上颌窦最大上下径、前后径、左右径分别为35.10±5.35mm、37.63±4.01mm和26.00±4.13mm。以上结果除眶下孔最大孔径男女组有显著性差异外,其余各组均无明显差异。结论：1.眶下管从横断面、冠状面及矢状面图像上观测,其整体走行大多位于上颌窦腔内,是导致上颌窦形态复杂、个体差异大的原因之一。2.尖牙窝横断面观大多有较明显凹陷，为上颌窦前壁最薄弱处，其上方紧邻眶下孔，孔内有眶下神经及血管通过。从尖牙窝处开窗入路的诸多手术，应注意保护眶下神经及血管。3．螺旋CT三维重建是研究上颌窦立体形态、空间位置及其毗邻结构的有效方法。

Objective：Three-dimensional reconstruction of the maxillary sinus was used to study the maxillary sinus three-dimensional shape,location and adjacent organs and adjacent structure for clinical implant and extraction of traumatic surgery,and,in same time,to provide reference for clinical research and accumulate data for anthropology youth database.Methods：34 volunteers（68 sides）,17 men and 17 women between the ages of 18 and 22,were selected.Selected volunteers did not have significant organic maxillary disease and had a neat upper and lower dentition and intact teeth. Experimental Methods： The subjects were examined at supine position, to listen canthus Line （OML） for the baseline through parallel scanning to the inferior orbital rim maxillary teeth occlusal surface. Dental applications softawre Dentalscan was used to reconstruct three - dimensional parameters. Results：The morphology infraorbital hole type of participants included horizontal oval （76.5%, 52 patients）, circular （23.5%, 16 cases）, Vice （1.5%, 1 case）, and single hole for the rest participants. Infraorbital tube wall thickness was 0.30±0.48mm, infraorbital hole largest aperture was 3.89±1.27mm, and canine fossa thickness was 1. 10±0.40mm. Maxillary sinus largest diameters from top to bottom, from front to back, and from left to right were about 35.10±5.35mm, 37. 63±4. 01± and 26.00±4.13mm, respectively. There was no significant difference between men and women, except largest infraorbital group aperture. Conclusion： 1. Infraorbital from the cross - sectional, coronal and sagittal images observation, mostly traveled Douqiang in the maxillary sinus. 2. Canine fossa cross - sectional view from the Depression is more obvious, and the anterior wall of the maxillary sinus is the most vulnerable parts of the department, prone to fracture. 3. Clinical line prompt when the maxillary sinus three drainage attention. Spiral CT three - dimensional reconstruction of the maxillary sinus is to study -dimensional shape, spatial location and its adjacent structure an effective way.