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目的 探讨蝶窦病变的CT形态学变化,以通过CT指引行蝶窦开窗术.方法 回顾性分析2008年7月至2015年7月98例蝶窦良性病变术前CT影像的特点,总结三种不同鼻内镜手术径路治疗蝶窦良性病变的效果.98例中,64例行鼻腔-嗅裂径路(上鼻甲-蝶窦自然口-蝶窦),24例行Messerklinger径路(前筛-后筛-蝶筛板-蝶窦),10例行Wigand径路(中鼻甲切除或外移-后组筛窦-蝶窦前壁-蝶窦).结果 术后随访6个月以上,蝶窦开窗处引流通畅,症状均完全控制,术中及术后未出现严重并发症.结论 鼻窦CT可以很好地指引蝶窦开窗术,三种手术径路均微创、安全、有效.“,”Objective To investigate the morphology of the sphenoid sinus using images from a computed tomography (CT) scan.Methods Image data acquired between July 2008 and July 2015 from 98 inpatients with sphenoid sinus diseases were retrospectively analyzed.The sphenoid sinus diseases were treated using one of three endoscopic surgical approaches.Sixty-four,24,and 10 patients underwent the nasal cavity-olfactory cleft,Messerklinger,and Wigand approaches,respectively.Results The patients received over 6 months of follow-up and the windows of the sphenoid sinuses remained unobstructed and the symptoms were controlled.There were no serious operative or postoperative complications.Conclusion ACT scan can guide endoscopic sphenoid sinus surgery,which is minimally invasive,safe,and effective.