导航内镜经鼻至颅颈交界区的解剖特点及临床应用研究

Study on the Anatomical Characteristics and Clinical Application of Navigation Endoscopy in the Area from Nose to Craniocervical Junction

目的探讨导航内镜经鼻至颅颈交界区的解剖特点及其相关临床应用。方法选取20例国人成人灌注好的新鲜冷藏头颈部比较完整尸头标本,分别对其进行CT薄层扫描和颅底重建,测量经鼻至颅颈交界区的重要解剖结构数据。在导航内镜下对该区域进行国人解剖暴露观察。最后利用鼻内镜经鼻对鼻咽部等颅颈交界区病变给予活检手术。结果经测量,从鼻前嵴至咽鼓管圆枕的距离为(62.28±3.35)mm,至破裂孔(前界)的距离为(72.68±3.59)mm;两侧破裂孔之间的距离为(22.20±2.89)mm;左右两侧咽鼓管咽口至中线的距离为(15.21±1.54)mm、(15.54±1.85)mm,经统计学分析后,左右两侧之间的差异无统计学意义(P>0.05)。结论通过导航内镜经鼻至颅颈交界腹区解剖学特点的研究,为鼻咽部颅颈交界区病变进行内镜下活检手术提供很重要的依据,从而提高在临床应用中的安全性。

Objective To explore the anatomic characteristics and clinical application of navigation endoscopy in the area from nose to craniocervical junction.Methods 20 fresh frozen head and neck specimens perfused by Chinese adults were selected for thin slice CT scanning and skull base reconstruction,and the important anatomical structure data of the junction area from nose to neck were measured.The anatomical exposure of Chinese was observed under navigation endoscopy.Finally,transnasal endoscopic biopsy was performed on the craniocervical junction lesions such as nasopharynx.Results The distance from the anterior nasal ridge to the circular pillow of eustachian tube was (62.28±3.35) mm,the distance from the anterior border of eustachian tube was (72.68±3.59) mm,the distance between the two sides of eustachian tube was (22.20±2.89) mm,the distance between the left and right eustachian tube pharyngeal orifice and the middle line was (15.21±1.54) mm and (15.54±1.85) mm.After statistical analysis,there was no significant difference between the left and right sides (P>0.05).Conclusion The study of the anatomic characteristics of the ventral region of the craniocervical junction by navigation endoscopy provides an important basis for endoscopic biopsy of the craniocervical junction lesions in the nasopharynx,so as to improve the safety in clinical application.