正常筛窦与蝶窦和视神经管毗邻关系的CT表现及临床意义

Reciprocal Anatomical Relationship between Normal Ethmoid Sinus, Sphenoid Sinus and Optic Canal on CT Scans and Its Clinical Significance

目的：观察后组筛窦与蝶窦和视神经管的相互关系，为诊断鼻窦疾病及临床手术提供依据。材料与方法：对３００例正常人筛、蝶窦进行ＣＴ扫描，其中３４例行横断加冠状扫描，２２１例行横断扫描，４５例行冠状扫描。结果：根据后组筛窦与蝶窦的位置关系，将后组筛窦分为蝶前型（５４％）、蝶侧型（３５％）和蝶上型（１１％）；根据后组筛窦与视神经管的位置关系，将后组筛窦分为管前型（４５％）、半管型（２３％）、全管型（１５．３％）、蝶鞍型（１５％）和管周型（１．７％）。３００例６００侧中，发现管周型蝶窦２０侧，占３．３％。结论：ＣＴ扫描是观察筛窦与蝶窦和视神经管解剖关系的首选方法，能为临床诊断鼻窦疾病和手术治疗提供依据，并提出了新的鼻窦分类方法。

Objective: To study the anatomical re lationship between ethmoid sinus, sphenoid sinus and optic canal with CT, and to provide relevant data for diagnosis and surgery of paranasal sinus diseases. Materials and Methods:CT scanning of ethmoid and sphenoid sinuses was performed in 300 normal subjects, including axial (n=221), coronal (n=45), and axial together with coron al (n=34) scanning. Results:Based on the relation of posterior ethmoid sinus t o sphenoid sinus, the posterior ethmoid sinus was divided into anterosphenoid (5 4%), laterosphenoid (35%) and superosphenoid (11%) types. According to the relat ion between posterior ethmoid and the optic canal, the posterior ethmoid sinus w as divided into anterocanal (45%), semicanal (23%), canal (15.3%), sellar (15%) and circumcanal (1.7%) types. Of 600 sphenoid sinuses in 300 cases, 20 (3.3%) pr esented circumcanal type. Conclusion: For observing the anatomical ralation between ethmoid sinus, sphenoid sinus and optic canal, CT scan is of first choice, which offers useful anatomical data for diagnosis and surgery. A new classification f or nasal sinuses is proposed.