蝶窦气化程度与蝶窦周围相关结构关系的影像分析

Study of the pneumatisation of sphenoid sinus and structures related to the sphenoid sinus in CT

目的研究成年人和青少年蝶窦气化及其与蝶窦周围相关结构的关系,为临床开展鼻内镜下经蝶窦颅底手术提供影像学基础。方法 100例成年人、50例青少年(10～18岁)行高分辨率CT冠状位和轴位扫描。结果蝶窦气化分蝶骨体气化和其他相关结构气化,成年人与青少年比较无显著性差异。300侧蝶窦,半鞍型和全鞍型258侧(86%),甲介型和鞍前型42侧(14%)。蝶骨大翼、蝶骨小翼、翼突、鞍背、枕骨的气化率分别为7.3%、8.0%、28.7%、9.3%、4.0%。颈内动脉半管型和全管型共139侧(46.3%),视神经半管型和全管型共174侧(58.0%),部分血管神经完全突入到蝶窦腔内,骨壁菲薄甚至缺如。颈内动脉、视神经管、圆管、翼管突入蝶窦的程度与蝶窦气化类型有关。结论蝶窦气化程度及颈内动脉、视神经管、圆管、翼管突入蝶窦的程度个体差异较大。与成年人相比,青少年蝶窦及蝶窦周围相关结构已发育成熟。

OBJECTIVE To study the pneumatisation of sphenoid sinus,explore the relation between the sphenoid sinus and structures related to the sphenoid sinus in CT. To provide data as basis for nasal endoscopic surgery of sella and clivus. METHODS High resolution CT scan in coronal and axial planes of 100 adults and 50 adolescents was studied. RESULTS The pneumatisation of sphenoid sinus can be subdivided into the pneumatisation of the sphenoid body and the one of related structures,and there are no distinct differences between adults and adolescents. The pneumatic rates of the greater wing,lesser wing,pterygoid process,sellar dorsum of sphenoid bone,and occipital bone are 7.3%,8.0%,28.7%,9.3%,and 4.0% respectively. The protuberant type of internal carotid artery,optic nerve,rotundum canal,and pterygoid canal were related with the degree of pneumatization of the sphenoid bone. CONCLUSION The pneumatisation of sphenoid sinus,the protuberant type of internal carotid artery,optic nerve,rotundum canal,and pterygoid canal,are difference among individual person. The sphenoid sinus and structures related to the sphenoid sinus had fully developed in adolescent as for nasal endoscopic surgery.