100例尸头额隐窝气房正常变异及额窦引流通道分析方法

doi:10.6040/j.issn.1673-3770.1.2018.005

山东大学耳鼻喉眼学报 ›› 2018, Vol. 32 ›› Issue (3): 31-36.doi: 10.6040/j.issn.1673-3770.1.2018.005

• 慢性鼻窦炎鼻息肉临床实践论著 • 上一篇下一篇

100例尸头额隐窝气房正常变异及额窦引流通道分析方法

吴彦桥¹,郑伟明²,李九胜³

1.白求恩国际和平医院耳鼻咽喉头颈外科, 河北石家庄 050000;
2.广州白云区石井人民医院五官科, 广东广州 510430;
3.晋中市榆次区人民医院耳鼻喉科, 山西榆次 030600

收稿日期:2018-02-24 出版日期:2018-05-20 发布日期:2018-05-20
通讯作者: 吴彦桥. E-mail:wyqhtm@163.com

Frontal recess classification and analysis of the frontal sinus passageway in 100 Chinese cadaver heads

WU Yanqiao¹, ZHENG Weiming², LI Jiusheng³

Department of Otolaryngology Head and Neck Surgery, Bethune International Peace Hospital, Shijiazhuang 050000, Hebei, China;

Received:2018-02-24 Online:2018-05-20 Published:2018-05-20

摘要/Abstract

摘要： 目的探讨中国人额隐窝气房变异种类及额窦引流通道类型,指导鼻科医生安全开放额窦。方法 100例尸头标本行解剖前薄层轴位CT扫描,按照额隐窝气房分类及“搭积木”式额窦引流通道分析方法,分析额窦引流通道,并通过解剖得以证实。结果中国人额隐窝气房发育变异较大,包括前方外侧的鼻丘气房、鼻丘上气房、鼻丘上额气房;内侧的额窦间隔气房;后方的筛泡、筛泡上气房、筛泡上额气房;100例标本中,鼻丘气房发生率95%;鼻丘上气房发生率为32%;鼻丘上额气房发生率为19%;筛泡上气房发生率为53.5%;筛泡上额气房(额泡气房)发生率为22%;额窦间隔发生率为23.5%;额窦引流通道形式有多种,按出现情况,从多到少为:前内侧型(右侧34例,左侧35例);前方型(右侧18例,左侧17例);内侧型(右侧14例,左侧13例);前外侧型(右侧10例,左侧10例);后方型(右侧6例,左侧7例);外侧型(右侧6例,左侧5例);直接型(右侧3例,左侧5例);后内侧型(右侧3例,左侧4例);夹缝型(右侧2例,左侧0例);后外侧型(双侧均有1例)。结论采用额隐窝气房分类法,按照“搭积木”方式分析额窦引流通道,是一个“以不变应万变”的方法,可以帮助鼻科医生术前了解额窦引流通道形式,术中安全、彻底开放额窦。

关键词: 额隐窝, CT三维成像, 额窦, 额窦引流通道

Abstract: Objective To classify types of frontal recesses using Chinese cadaver heads, in order to simplify frontal recess classification and to allow easier and safer construction of the frontal sinus passageway for frontostomy. Methods A total of 100 Chinese cadaver heads underwent sliced sinus computed tomography scans. Data describing the frontal recess were summarized based on the International Frontal Sinus Anatomy Classification system. The frontal sinus passageway was analyzed and verified via cadaver dissection. Results The frontal sinus in Chinese cadaver heads exhibits very large variation in its composition. Cells were present in scans as follows: agger nasi cells in 95%; supra agger nasi cells in 26% of T1 scans, 6% of T2 scans; supra agger frontal cells in 19%; supra bulla cells in 53.5%; supra bulla frontal cells in 22%; and frontal septal cells in 23.5%. Agger nasi, supra agger, and supra agger frontal cells belong to the anterior frontal recess group; frontal septal cells belong to the medial frontal recess; supra bulla and supra bulla frontal cells belong to the posterior group. We classified the frontal sinus passageway into 10 types(in descending frequency): anterior medial(right side, 34 cases; left side, 35 cases); anterior(right side, 18 cases; left side, 17 cases); medial(right side, 14 cases; left side, 13 cases); anterior lateral(right side, 10 cases; left side, 10 cases); posterior(right side, 6 cases; left side, 7 cases); lateral(right side, 6 cases; left side, 5 cases); direct(right side, 3 cases; left side, 5 cases); posterior medial(right side, 3 cases; left side, 4 cases); slit(right side, 2 cases; left side, 0 cases); and posterior lateral(1 case for both sides). Conclusion Use of the International Frontal Sinus Anatomy Classification and the three-dimensional frontal sinus passageway methods may help rhinologists easily construct frontal sinus passageways and safely perform frontostomy.

Key words: Frontal sinus, Frontal recess, Frontal sinus passway, Three-dimensional computed tomographic imaging

中图分类号:

R765.4

吴彦桥,郑伟明,李九胜. 100例尸头额隐窝气房正常变异及额窦引流通道分析方法[J]. 山东大学耳鼻喉眼学报, 2018, 32(3): 31-36.

WU Yanqiao, ZHENG Weiming, LI Jiusheng. Frontal recess classification and analysis of the frontal sinus passageway in 100 Chinese cadaver heads[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2018, 32(3): 31-36.

参考文献

[1] Wormald PJ. The agger nasicell: the key to understanding the anatomy of the frontal recess[J]. Otolaryngol Head Neck Surg, 2003, 129(5):497-507.
[2] Wormald PJ. Surgery of the frontal recess and frontal sinus[J]. Rhinology, 2005, 43(2):82-85.
[3] Wormald PJ. The axillary flap approach to the frontal recess[J]. Laryngoscope, 2002, 112(3):494-499.
[4] Wormald PJ, Hoseman W, Callejas C, et al. The International Frontal Sinus Anatomy Classification(IFAC)and Classification of the Extent of Endoscopic Frontal Sinus Surgery(EFSS)[J]. Int Forum Allergy Rhinol, 2016, 6(7):677-696.
[5] Wormald PJ. Three-dimensional building block approach to understanding the anatomy of the frontal recess and frontal sinus[J]. Oper Tech Otolayngol Head Neck Surg, 2006, 17:2-5.
[6] Wormald PJ, Bassiouni A, Callejas CA, et al. The International Classification of the radiological Complexity(ICC)of frontal recess and frontal sinus[J]. Int Forum Allergy Rhinol, 2017, 7(4):332-337.
[7] 张罗,周兵,韩德民.额隐窝临床解剖和额窦手术径路[J].中国耳鼻咽喉头颈外科, 2004, 11(4):262-268.
[8] 张罗,周兵,葛文彤,等.鼻丘在鼻内镜下额窦开放术中的作用[J].中华耳鼻咽喉头颈外科杂志, 2005, 40(7):493-497. ZHANG Luo, ZHOU Bing, GE Wentong, et al. Endoscopic fronta l sinus surgery through agger nasi cell approach[J]. Chin J Otorhinolaryngol Head Neck Surg, 2005, 40(7):493-497.
[9] 周兵,韩德民,刘华超,等.鼻内镜下额隐窝解剖特征与额窦开放手术[J].中华耳鼻咽喉科杂志, 2003, 38(5):367-369. ZHOU Bing, HAN Demin, LIU Huachao, et al. Endoscopic anatomiccharacteristics of frontal recess and frontal sinus surgery[J]. Chin J Otorhinolaryngol, 2003, 38(5):367-369.
[10] 王鹏,韩晓东,杨贵,等.额隐窝区域结构立体影像研究[J].临床耳鼻咽喉头颈外科杂志, 2014, 28(17):1305-1310. WANG Peng, HAN Xiaodong, YANG Gui, et al. Computed tomographic images analysis of frontal recessanatomy based on three-dimension reconstruction[J]. J Clin Otorhinolaryngol, 2014, 28(17):1305-1310.
[11] 王立银,王振海. 钩突上端附着及额窦引流位置的冠状位CT观察[J]. 山东大学耳鼻喉眼学报, 2009, 23(5):28-30. WANG Liyin, WANG Zhenhai. Coronal computed tomographic analysis of the uncinate process and frontal sinus drainage pathway[J]. J Otolaryngol Ophthalmol Shandong Univ, 2009, 23(5):28-30.

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100例尸头额隐窝气房正常变异及额窦引流通道分析方法

Frontal recess classification and analysis of the frontal sinus passageway in 100 Chinese cadaver heads

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