圆孔前入路穿刺的解剖结构观察

Anatomical observation of piercing into foramen rotundum in the anterior approach

目的结合CT三维重建及颅骨的解剖结构观察,探究一种可以依据的穿刺线路,提高穿刺的成功率。方法通过对110例的患者头颅的三维CT图像测量,得出圆孔在上颌骨前壁投影点(B),颧下穿刺点(A),A和B点的连线,通过21例头颅标本弯针穿刺入圆孔后,测量AB线与穿刺针的角度关系。结果圆孔至眶下壁直线的垂直距离(7.93±2.15)mm。左右侧及性别年龄比较,P>0.05,无统计学差异。圆孔中心点与M线的距离(19.91±1.92)mm。左右侧及年龄比较,P>0.05,无统计学差异,性别比较,P<0.01,有统计学差异。圆孔至眶上裂距离(3.85±1.34)mm,圆孔至眶上裂距离左右侧有统计学差异。头颅上标记鼻背中线外2.0 cm平面与距眶下缘下方8 mm的点为圆孔在上颌骨前壁的投影点(B),AB线与穿刺针直线的角度平均值为1.35°。结论颧下穿刺点(A)和圆孔投影点(B)的连线在圆孔前入路穿刺中提供一个可靠的依据路线。

Objective Combined CT three-dimensional reconstruction with skull anatomy observation,to explore a way which can be based on to puncture and improve the success rate of puncturing. Method 110 cases of patients with skull three-dimensional CT image were measured to obtain the projection point of foramen rotundum（ FR） in maxillary anterior wall（ B）,under the zygomatic puncture point（ A）,connecting point A with point B. After the curved needle piercing into the foramen rotundum by 21 skull specimens,the angle between AB line and the needle line was measured. Results The linear vertical distance was（ 7.93± 2.15） mm between the foramen rotundum and the line of the orbital bottom. There was no statistical difference in the comparison of the left and right side,the age and the gender,P〈0.05. The distance was（ 19.91±1.92） mm between the foramen rotundum and the M line. There was no statistical difference in the comparison of the left and right side and the age,P〈0.05. There were statistically significant differences in the gender comparison,P〈0.01. The distance between foramen rotundum and the supraorbital fissure（ SOF） was（ 3.85±1.34） mm. There were statistical differences between the left and the right of the distance which was between foramen rotundum and the supraorbital fissure. The projection point（ B） of the foramen rotundum was in maxillary anterior wall in the skull which intersected the plane outside the center line of the nasal dorsum 2.0 cm with the plane and below orbital bottom plane 8 mm. The average value of the angle was 1.35° between AB line and the needle. Conclusion It provides a reliable line for piercing into foramen rotundum in the anterior approach which is connected with under the zygomatic puncture point（ A） and the projection point of foramen rotundum（ B）.