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目的:探讨鼻内镜下额嘴进路治疗额窦病变的可行性。方法:1对20例冷冻尸头进行CT扫描,在Mimics图像工作站进行图像处理和多平面重组成像,对手术入路点处相关解剖参数进行测量;2应用Sinuses TracheaⅠ软件重建额窦及其引流通道、周围气房三维可视结构;3参照CT图像和上述数据,对尸头模拟额嘴进路额窦手术操作,寻找相关解剖标志,观察可能出现的手术并发症。结果:1额嘴位于中鼻甲前端颅底附着点处,呈白色骨性隆起,位置相对固定,额窦口位于其后或稍靠上方。2中鼻甲垂直板与眶纸板之间的距离为(7.61±1.34)mm,手术入路点处额嘴的厚度为(3.27±0.91)mm。3额窦及其引流通道三维成像呈锥形,尖端向下,经额窦口移行到额窦引流通道。额窦口的前方由额嘴包绕,额嘴的前上方与额窦底相连。40°鼻内镜下找到额嘴,并由此进路完成额窦开放手术操作。结论:鼻内镜下额嘴进路行额窦手术是可行的,操作简便,容易掌握。在额嘴“L”之间区域行额窦手术是安全的。
Objective: To explore the feasibility of nasal endoscopic beak approach to treat frontal sinus lesions. Methods: Twenty frozen cadaver heads were scanned by CT, image processing and multiplanar reconstruction were performed at Mimics workstation, and relevant anatomical parameters were measured at the approach point of the surgery. Sinuses Trachea Ⅰ software was used to reconstruct the frontal sinus and its drainage channels , Three-dimensional visual structure of the surrounding air space; 3 with reference to CT images and the above data, the corpse head simulation of beak approach sinus surgery operation, looking for relevant anatomic landmarks to observe the possible complications. Results: 1 beak is located in the middle turbinate front skull base attachment point, white bony bulge, the location is relatively fixed, the frontal ostia located in the post or slightly above. 2 The distance between the middle turbinate vertical plate and the orbital cardboard was (7.61 ± 1.34) mm, and the thickness of beak at the surgical approach point was (3.27 ± 0.91) mm. 3 frontal sinus and its drainage channel three-dimensional imaging was tapered, the tip down, by the frontal sinus migration to the frontal sinus drainage channel. The forehead of the frontal ostium beak surrounded by beak in front of the front and the front of the sinus connected. 40 ° nasal endoscope to find the beak, and the way to complete the frontal sinus surgery. CONCLUSION: Nasal endoscopic beak approach to frontal sinus surgery is feasible, easy to operate and easy to grasp. Regional besolation between beaks “L” is safe.