山东大学耳鼻喉眼学报 ›› 2011, Vol. 25 ›› Issue (2): 54-56.

• 论文 • 上一篇    下一篇

鼻内镜下鼻中隔正中入路治疗额窦病变的应用解剖

马俊伟, 刘婷婷,张念凯   

  1. 青岛大学医学院附属医院耳鼻咽喉-头颈外科, 山东 青岛 266003
  • 收稿日期:2010-10-12 修回日期:2011-01-10 出版日期:2011-04-16 发布日期:2011-04-16
  • 通讯作者: 张念凯(1963- )男,主任医师,主要从事鼻科学研究。Email:znkent@yahoo.com.cn
  • 作者简介:马俊伟(1983- ),男,硕士研究生,主要从事鼻科学研究。Email:2008majunweigood@163.com

Applied anatomy of endoscopic frontal sinus surgery  through the nasal septum

 MA Jun-wei, LIU Ting-ting, ZHANG Nian-kai   

  1. Department of Otolaryngology & Head and Neck Surgery, Affiliated Hospital of Medical College of  Qingdao University, Qingdao 266003, Shandong, China
  • Received:2010-10-12 Revised:2011-01-10 Online:2011-04-16 Published:2011-04-16

摘要:

目的     探讨鼻内镜下鼻中隔正中入路治疗额窦病变的解剖学基础。方法    在30例经甲醛固定的成人尸头上对鼻中隔与额窦相邻解剖结构分别进行解剖学测量。结果    中鼻甲垂直部与水平部交接点与鼻中隔相对应的点称为M点,M点到鼻骨的水平距离为(20.07±6.21)mm, M点到额窦底内侧最前端距离为(27.59±7.71)mm, M点到额窦底内侧最后端距离为(25.35±6.69) mm, 中鼻甲根部颅底附着处到第一嗅丝的距离为(5.53±1.41)mm,额窦底前后径为(7.62±2.45)mm, 额窦底左右径为(9.41±3.37)mm, 额窦间隔上下径为(16.97±3.23)mm, 额窦间隔前后径为(12.34±2.23)mm。中鼻甲根部颅底附着处与第一嗅丝的连线与鼻颅底呈65°角。结论    鼻中隔顶端前份和额窦底相连,中鼻甲垂直部和水平部交接点与鼻中隔相对应的点即M点以及中鼻甲根部颅底附着处与鼻中隔夹角处的第一嗅丝是鼻内镜下鼻中隔正中入路治疗额窦病变手术的重要安全标志,通过尸头解剖模拟鼻中隔正中入路和解剖学测量,认为鼻中隔手术入路是可行的。

关键词: 额窦;鼻内镜检查;解剖学;嗅丝

Abstract:

Objective    To discuss the anatomy of endoscopic frontal sinus surgery through the nasal septum.    Method    Adjacent anatomical structures of the nasal septum and the frontal sinus were measured on 30 adult cadaveric heads fixed by formalin.    Results    The intersection formed by the pars perpendiculars and horizontal part of the middle nasal concha, which corresponded to the nasal septum was called the M point. The horizontal distance from the M point to the nasal bone was(20.07±6.21)mm,  the distance from the M point to the anterior extremity of the frontal sinus was (27.59±7.71)mm,  from the M point to the posterior extremity of the frontal sinus was (25.35±6.69) mm, and from the root of the middle nasal concha to the first fila olfactoria was (5.53±1.41)mm. The anteroposterior diameter of the proximal wall of the frontal sinus was (7.62±2.45)mm, the coronary diameter of  the proximal wall of the frontal sinus was (9.41±3.37)mm, the transvasal diameter of the septum of the frontal sinus was (16.97±3.23)mm, and the anteroposterior diameter of the septum of the frontal sinus was(12.34±2.23)mm. The root of the middle nasal concha attachment with the skull base and the first fila olfactoria angled at 65 degree.    Conclusion    The top front of the nasal septum is connected to the fundus of the frontal sinus,  both the M point and the first fila olfactoria are important safety signs of endoscopic frontal sinus surgery through the nasal septum. Frontal sinus surgery through the nasal septum is feasible.

Key words: Frontal sinus; Endoscopy;  Anatomy;  Fila olfactoria

中图分类号: 

  • R765.2
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