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目的:通过经鼻内镜行蝶窦外侧壁尸头解剖,为临床鼻内镜下蝶窦外侧壁相关手术提供解剖学参考。方法:选取经10%甲醛防腐处理的国人成人湿性尸头10具(20侧),鼻内镜下经鼻-蝶窦手术入路,暴露蝶窦腔,在0°和30°鼻内镜下确认蝶窦外侧壁骨性隆起,观察视神经和颈内动脉与毗邻结构的关系,以直尺、量角器等测量工具分别测量视神经管和颈内动脉骨性隆起与鼻小柱、鞍底中线的距离和角度。结果:鼻内镜下可见蝶窦外侧壁上视神经管与颈内动脉骨性隆起呈“八”字形关系,向蝶窦腔凸入的程度及两者间距离因人而异,沿颈内动脉追踪可暴露海绵窦外侧壁;测得视神经管眶口内壁中点、颈内动脉骨性隆起前端到鼻小柱的平均距离分别为(75.33±5.59)mm和(81.02±5.29)mm,到鞍底中线的平均距离分别为(5.81±1.52)mm和(5.53±1.47)mm;视神经管眶口内壁中点到鼻小柱连线与鼻底的夹角平均为(53.4±4.1)°。结论:以鼻小柱及鞍底中线为参考点,在鼻内镜下经鼻-蝶窦手术径路进行的蝶窦外侧壁解剖学形态观察和相关测量数据可为临床医生提供相应指导。
OBJECTIVE: To dissect the cadaveric end of the sphenoid sinus by endoscopic sinus surgery and provide anatomic reference for the operation of the lateral wall of the sphenoid sinus under endoscopic sinus surgery. Methods: 10 adult (10 sides) of adult human corpse with anticorrosive treatment of 10% formaldehyde were selected. Nasal-sphenoid sinus surgery under nasal endoscopy was performed to expose the sphenoid sinus cavity. Under 0 ° and 30 ° endoscopy The relationship between the optic nerve and the internal carotid artery and the adjacent structures was observed. The distance between the optic canal and the internal carotid artery was measured by means of measuring tools such as ruler and protractor And angle. Results: Under endoscopic sinus surgery, the optic canal on the lateral wall of sphenoid sinus showed “eight” -shaped relationship with the internal carotid artery bony protrusion. The degree of protrusion to the sphenoid sinus cavity and the distance between the two were different from one to another. The mean distance from the anterior wall of the internal carotid artery to the columella was (75.33 ± 5.59) mm and (81.02 ± 5.29) mm respectively, to the saddle The mean distances from the midline of the optic canal to the nasal column were (5.81 ± 1.52) mm and (5.53 ± 1.47) mm, respectively. The average angle between the medial orbital wall of the optic canal and the nasal column was (53.4 ± 4.1) °. CONCLUSIONS: Using the columella and midline of the sella as the reference point, anatomical observation of the lateral sphenoid sinus wall and relevant measurement data under nasal-sphenoid sinus approach under endoscopic sinus surgery may provide guidance to clinicians.