上颌窦口扩大手术与蝶腭动脉分支关系的外科解剖研究

Surgical Anatomy Study Between the Relationship of Sphenopalatine Artery and Maxillary Sinus Operation

目的:了解人体上颌窦口扩大手术与蝶腭动脉分支的解剖关系。方法:30侧动脉灌注乳胶10%福尔马林固定的成人头部标本,不计性别和年龄,在立体放大镜下观察鼻中隔,中鼻道的结构和血管分布。结果:上颌动脉在蝶腭孔处分为蝶腭动脉一终支,经蝶腭孔到鼻腔。其分支供应鼻腔外侧壁,鼻窦及鼻中隔。蝶腭动脉的分支,鼻后外侧动脉的外径为(1.05±0.09)mm,其分支至中鼻甲动脉和下鼻甲动脉,其外径分别为(0.91±0.09)mm和(0.96±0.09)mm。蝶腭动脉的下鼻甲分支在下鼻腔后端前方的距离约为(11±3)mm。在行上颌窦口开放手术时,若距中鼻甲后约1.5cm的距离,不易伤及鼻后外侧动脉。结论:上颌窦口扩大手术中不能单纯以上颌窦开口位置,作为向后上扩大的自然标志,在中鼻甲后端1～1.5mm处,开放上颌窦口较为安全,同时应避免伤及蝶腭动脉的分支及鼻后外侧动脉。

Objecive：To understanding relationship between human maxillary sinus surgery and branches of sphenopalatine artery anatomy. Methods：30 cases of latex artery in 10% formalin fixed adult head specimens,excluding sex and age,were observed under a magnifying glass in the three-dimensional,nasal septum,middle meatus and the vascular structure. Results：Maxillary artery had branch as sphenopalatine artery,in the sphenopalatine foramen into the nasal cavity. Its branches supplied the lateral wall of the nasal cavity,paranasal sinuses and nasal septum. Sphenopalatine artery branches,posterior lateral nasal artery diameter was 1.05±0.09mm,the branch to the middle turbinate artery and inferior turbinate artery,its diameter was 0.91±0.09mm and 0.96±0.09mm. The distance between nasal inferior turbinate artery and ending of nasal inferior turbinate is about 11±3mm. Maxillary sinus surgery,if the distance from middle turbinate was over 1.5cm,it could not hurt posterior lateral nasal artery. Conclusion：Maxillary sinus surgery can not simply expand the open position of the maxillary sinus,as back 1-1.5mm on the expansion of the natural signs in the nasal cavity,open maxillary sinus is more secure,and should avoid harming sphenopalatine artery,posterior lateral nasal artery branches.