鼻内鼻窦手术损伤泪道的解剖学分析

Anatomical consideration for the injury of dacryocyst and nasolacrimal duct during intranasal sinus surgery

为了减少或避免易内鼻窦手术损伤泥道，在20具成人尸头标本上，观测泪道与鼻腔外侧壁的毗邻关系。发现前筛气房与泪囊窝关系密切，气房侵及泪骨占87．5％；鼻泪管与钩突上端游离线之间距离为6.74±1．72mm，距离筛漏斗前界3．44±0．75mm，距上颌窦鼻内开口为5．50±3．73mm。鼻泪管开四位于下鼻道前端鼻甲附着处。研究表明，前筛房、钩突切除和上颌窦鼻内开窗手术范围，如果过于向前，容易损伤泪道。

Based on dissection and measurement on 20 adult head cadavers, there is the close relationship between lacrimal duct and lateral wall of the nasal cavity. The cells of anterior ethmoid sinus were classified into three degrees, according to the relationship between the anterior ethmoid sinus and the lacrimal sac fossa. The average distance is 6. 74± 1. 72 mm between the nasolacrimal duct and the upper part of the uncinate process, 3. 44±0. 75 mm and 5. 50±3. 73 mm from the riasolacrimal duct to ethmoidal infundibulum and the maxillary ostium. The orifice of the duct most commonly opens under the insertion of the inferior turbjnate anteriorly. To perform intranasal sinus surgery, the safest area and key operation approach were discussed.