与鼻内镜手术相关的鼻泪管解剖测量

ANATOMY STUDY OF NASOLACRIMAL DUCT RELATING TO ENDOSCOPIC OPERATION

①目的 熟悉鼻泪管的局部解剖关系 ,为鼻内镜下鼻泪管的手术提供依据。②方法 对 5 6侧正中矢状位切开尸头的鼻泪管进行解剖学测量。③结果 鼻泪管开口位于下鼻道前 1/ 3段顶或侧壁 (30侧 ,2 6侧 )。鼻泪管长度为 (15 .99± 2 .5 2 )mm ,鼻泪管上口径平均 2 .97mm ,鼻泪管中段管径 4.2 0mm ,鼻泪管上口内侧壁厚平均 0 .73mm ,中段内侧壁厚平均 0 .5 5mm ,鼻泪管下口前缘至前鼻棘距离平均 2 1.97mm ,下口前缘至下鼻甲前缘附着处的距离平均为 10 .5 4mm ,上颌窦开口前缘到鼻泪管后壁的距离平均 3.82mm ,鼻泪管长轴与眉间至前鼻棘连线的夹角为 8.74°± 1.39° ,以上各指标左右侧比较差异无显著性 (t =- 0 .983～ 1.481,P >0 .0 5 )。④结论 鼻泪管上口位于鼻丘隆突下缘 ,下口位于下鼻道前端顶或侧壁 ,是鼻内镜鼻腔泪囊造口术的重要标志。

Objective\ To know the topographic anatomy of nasolacrimal duct so as to provide the basis for endoscopic operation for the duct. \ Methods\ 56 median sagittal section skulls were used for investigation of the anatomy of nasolacrimal duct. Results\ The orifices of nasolacrimal ducts located on the top(30/56) and lateral wall(26/56) of inferior nasal meatus. The duct length was (15.99±2.52)mm. The mean diameter of the canals upper ostium was 2.97mm. The diameter of the middle portion along the canal was 4.20mm. The thickness of the canals upper ostium inner wall was 0.73mm and of the inner wall of middle portion was 0.55mm. The mean distance between the canals inferior ostium and the front nasal spine was 21.97mm. The distance between the canals inferior ostium and the front adjacent portion of the inferior turbinate was 10.54mm. The distance between the front margin of maxillary sinus ostium and the posterior wall of the canal was 3.82mm. The angle between the canals long axial and the line from the frontal tuber to the front nasal spine was 8.74°±1.39°. The difference of above parameters was not significant as compared with the sides( t= -0.983-1.481, P >0.05).\ Conclusion\ The upper ostium of nasolacrimal canal located in the inferior margin of nasal spine tuber, the inferior ostium located on the top of inferior turbinate or lateral wall . All these are important marks for nasal dacryocystostomy by endoscopy.