鼻内窥镜引导下筛动脉结扎术的应用解

Applied anatomy of the ligation of ethmoidal artery with nasal endoscope

目的 :为鼻中隔严重出血功能性鼻内窥镜引导下筛动脉结扎提供解剖学基础。方法 :手术显微镜下解剖 2 0侧成人鼻中隔的动脉。结果 :鼻中隔血供属多源性 ,主要来自鼻后中隔动脉上支、下支 ,筛前、筛后动脉 ,它们入鼻中隔处外径分别为 (0 .9± 0 .2 )、(0 .7± 0 .1)、(0 .4± 0 .1)、(0 .3± 0 .1)mm ,筛前、筛后动脉入鼻中隔处与鼻小柱前缘距离分别为 (5 .1± 0 .3 )cm和 (6.3± 0 .3 )cm ,入鼻中隔处与鼻小柱基底连线和鼻腔底壁的夹角分别为 (5 5 .5°± 4.4°)和 (4 5 .0°± 3 .5°) ,鼻中隔段主干长分别为 (1.3± 0 .4)、(1.0± 0 .2 )cm。筛前、筛后动脉主要分布于鼻中隔上部。结论 :功能性鼻内窥镜引导下筛动脉结扎具有可行性。

Objective: To provide anatomic basis for the treatment of severe bleeding of nasal septum by ligating ethmoidal artery with functional nasal endoscope. Methods:Twenty sides of adult cadaveric nasal septum were dissected operating microscope.Results: Vascular origins in nasal septum and there are superior and inferiors septal posterior nasal artery, anterior ethmoidal artery and posterior ethmoidal artery.Their external diameter was 0.9±0.2?0.7±0.1?0.4±0.1 and 0.3±0.1 mm respectively.The distances from the point where anterior and posterior ethmoidal artery entering nasal septum to nasal columella was 5.1±0.3 and 6.3±0.3 cm respectively.Angles between line of entering nasal septum and nasal columella and floor of nose was 55.5°±4.4° and 45.0°±3.5°, and their trunks in nasal septum were 1.3±0.4 and 1.0±0.2 cm long.Anterior and posterior ethmoidal artery mainly spread over superior part of nasal septum. Conclution: The ligation of ethmoidal artery leading by functional nasal endoscope is feasible.