单鼻孔经蝶入路垂体腺瘤切除术中蝶窦前壁的解剖学研究

Anatomical study of anterior wall of sphenoid sinus for resecting pituitary adenomas through single nostril transsphenoidal approach

目的通过对成人湿性头颅标本的解剖和数据测量,量化蝶窦前壁,为单鼻孔经蝶入路到鞍区的显微解剖提供准确定位数据。方法对20例(40侧)不同性别的成人头颅湿性标本进行血管灌注染色后,模拟单鼻孔经蝶入路垂体腺瘤切除手术,对蝶窦前壁进行解剖及数据测量。结果前鼻嵴至蝶窦开口上端中点(57.8±4.9)mm;蝶窦口上端中点距中线(3.4±1.0)mm。结论蝶窦口是经鼻蝶入路手术的重要解剖标志,以鼻腔底为基线矢状夹角为31.5°,沿鼻中隔进入约57.8 mm,再偏离鼻中隔约3.4 mm,即为蝶窦开口的上端中点。

To provide anatomic data for accurately localizing aperture of sphenoidal sinus in endoscopic transsphenoidal sella surgery by the way of dealing with aduh skull examples. Methods The anterior wails of sphenoid sinus were observed and measured on 20 adult dry skull examples which have been fixed before. Results The average distance from the anterior nasal spine to the ostium of sphenoidal sinus was （57.8± 4.9） mm. The average distance from the top of ostium of sphenoid sinus to the median line was （3.4± 1.0） mm. Conclusions The ostium of sphenoidal sinus is a very important anatomical landmarks in the single nostril transsphenoidal approach surgery. The angle of the bottom of nasal cavity with the ostium of sphenoidal sinus is 31.5°. The average distance from the anterior nasal spine to the ostium of sphenoidal sinus is 57.8mm along the nasal septum and the anterior wall of the sphenoid sinus is opened from the inferior pole of the ostium of sphenoidal sinus strictly along the middle-line.