蝶窦的气化发育对蝶鞍区手术的影响

Development of the sphenoid sinus affects the surgical approach via saddle area

目的 :了解蝶窦的气化发育对蝶鞍区手术的影响。 方法 :对 50例成人头颅行冠状位、矢状位及水平位薄层 CT扫描 ,观测蝶窦气化发育的情况 ,根据蝶窦向蝶骨体、蝶骨小翼及鞍背气化的程度进行分型分度。 结果 :1 0 0例蝶窦中属甲介型为 4 % ,鞍前型为 1 8% ,半鞍型为 1 8% ,全鞍型为 1 4% ,鞍枕型为 4 6% ;蝶窦的横径左、右侧分别为 1 8.4 8mm和 1 7.58mm;前后径左、右侧分别为 2 2 .2 0 mm和 2 0 .82 mm;上下径左、右侧分别为 2 1 .0 2 mm和 2 0 .3 8mm。蝶窦外侧壁至正中线的距离左、右侧分别为 1 4.78mm和 1 5.1 8mm。 结论 :蝶窦的气化发育及分型分度为经蝶鞍区手术提供了解剖学依据。

Objective: : To investigate whether development of the sph e noid sinus affect the surgical approach via saddle area. Methods: The pneumatization of sphenoid sinus of 50 cadaver heads was studied through t hinner CT scanning of coronal, sagittal and axial position. The sphenoid sinus w as classified according to the degree of pneumatization of sphenoid sinus toward s sphenoid bone, small wing of sphenoid bone and epippium. Results: There were 4% conchal, 18% pre-sellar, 18% semi-sellar, 14% sellar, 46% sellar -occipital in 100 sphenoid sinus cases. The transversal diameter of left and ri ght was 18.48 mm and 17.58 mm; The sagittal diameter of left and right was 2 2.20 mm and 20.82 mm, The vertical diameter of left and right was 21.02 mm and 2 0.38 mm. The distance between centre track and the later wall of sphenoid sinus was 14.78 mm in left side and 15.18 mm in right side. Conclusion: Thinner CT scanning with coronal and sagittal position can clearly show pneum atization of sphenoid sinus on both sides. Different pneumatization of sphenoid sinus provide anatomical basis for choosing operation approach.