翼腭窝神经阻滞相关解剖及其临床意义

Anatomy and Clinical Research of the Pterygolatine Fossa Nerve Block

目的：探讨翼腭窝神经阻滞相关解剖及其临床意义.方法：在33个干性颅骨标本上对翼腭窝相关孔道和穿刺路径进行解剖观测.应用SPSS17.0分析并比较相关解剖数据.结果：不同穿刺测量法测量翼腭窝的长度,分别为：颧弓下法之侧入法,左侧为（54.87±3.44）mm、右侧为（54.79±2.81）mm;颧弓下法之侧前入法,左侧为（52.90±3.39）mm、右侧为（52.98±2.76）mm;颧骨上法,左侧为（47.59±2.93）mm、右侧为（47.34±3.05）mm.穿刺针与颅骨正中矢状面的角度上述3种方法依次为：左侧（75.5±6.4）°、右侧为（73.4±4.7）°,左侧（83.0±7.1）°、右侧（82.7±5.2）°,左侧（101.4±7.4）°、右侧（101.9±6.6 ）°.结论：翼腭窝神经阻滞术以颧骨上法、颧骨下法应用较多.以颧骨上法风险较小,效果较好.

Objective：To explore the anatomy and the clinical use of the pterygolatine fossa nerve block. Methods：Anatomical parameters and communications of the pterygolatine fossa were obtained from 33 dried - specimen skulls, the data were analyzed by SPSS17.0 and compared. Results： Major clinical approaches and their results are ： Infrazygomatic approach - Flank front approach ： left （ 54.87 ±3.44） mm, right （ 54.79 ±2.81 ） mm; Infrazygomatic approach - Flank front approach： left （52.90 ± 3.39） mm, right （52.98 ±2.76） mm; Suprazygomatic approach： left（47.59 ±2.93 ） mm, right（47.34 ± 3.05 ） mm; the 3 major clinical approaches＇ angles （ between middle sagittal plane of skull and puncture needle） is ： left （ 75.5 ± 6.4 ） o , right （73.4 ±4.7）°; left （83.0±7.1）°,right（82.7 ±5.2）°; left（101.4±7.4） °,right（101.9 ±6.6）°. Conclusions：Suprazygomatic approach and infrazygomatic approach are the two major ways of the pterygolatine fossa nerve block. Suprazygomatic approach is recommended.