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1、鼻内镜下经蝶窦蝶鞍区手术中蝶窦前壁的应用解剖514?第二军医2006May;27（5）AcadJSecMIlMedUniv〜鼻内镜下经蝶窦蝶鞍区手术中蝶窦前壁的应用解剖9■论着？刘环海，廖建春党瑞山，胡国汉,邓彬华，张晖，王君玉,范静平（1•第二军医大学长征医院耳鼻咽喉科，上海200003;2.第二军医大学基础医学部人体解剖学教研室，上海200433）［摘要］目的:为鼻内镜下经蝶窦蝶鞍区手术准确寻找蝶窦口,避免损伤蝶腭动脉提供解剖学资料•方法:在15例国人头颅标本上,用游标卡尺和角规对30侧蝶窦前壁进行解剖学（走行，位置，外径以及与相关结
2、构的距离）观察和测量•结果:鼻小柱根部至蝶窦口下极及蝶腭孔的距离分别为（60.40〜3.21,58.10〜72.76)mm和(62.14±1.93,59.5O〜73.40)mm;蝶腭孔至蝶窦口下极的距离为(12.20±l.lO,8.1O~16.35)mm,在蝶腭孔处蝶腭动脉的外径为(1.99±0・13,l・50〜2.80)mm;蝶窦口下极至鼻中隔后上动脉及鼻中隔后下动脉的距离分别为(3.49+0.24,2.78~5.20)mm和(6.42±1.08,4.3O~8.50)mm.结论:蝶窦口是经蝶窦蝶鞍区手术的重要标志;开放蝶窦时宜从蝶窦口内
3、下方开放,以免损伤蝶腭动脉.［关键词］蝶窦;蝶鞍;蝶窦口;蝶腭动脉［中图分类号］R323・1;R765・9［文献标识码］A［文章编号10258—879X(2006)05—0514—03AppliedanatomyofanteriorwallofsphenoidsinusfortranssphenoidalendoscopicsellasurgeryLIUHuan-har,LIAOJian-chun,DANGRui一shan.,HUGuo-han,DENGBinhua,ZHANGHuiWANGJumyu,FANJing・ping.(l.D
4、epartmentofOtorhinolaryngology,ChangzhengHospital,SecondMilitaryMedicalUniversity,Shanghai200003,China2.DepartmentofHumanAnatomy,CollegeofBasicMedicalSciences,SecondMilitaryMedicalUniversity,Shanghai200433)[-ABSTRACTJObjective:Toprovideanatomicdataforaccuratelylocalizinga
5、pertureofsphenoidalsinuswithouti-uryingsphe一nopalatinearteriesinendoscopictranssphenoidalsellasurgery.Methods:Theanteriorwallsofspheroidsinuswereobservedandmeasured(1ayout,position,externaldiamete「,distancestootherstructuresofinterest)withaverniercaliperandananglegaugeonl
6、5adultcadavers.Results:Thedistancesfromtherootofcolumellanasitotheinforiorpoleofsphenoidalsinusapertureandthesphenopalatineforamenwere(60.40±3.21,58.10一72.76)mmand(62.14±1.93,59.50—73・40)mm,respectively.Thedis—tancefromtheinforiorpolesphenoidalsinusaperturetothesphenopala
7、tineforamenwas(12.20土1.10,8.10一16.35)mm.Thediameterofthesphenopalatinearterywas(l・99±0・13,1.50一2.80)mm.Thedistancesfromtheinforiorpoleofsphenoidalsinusaperturetothesuperiorandinferiorposteriorarteryofnasalseptumwere(3.49土0.24,2.78—5.20)mmand(6.42±1.0&4.30一8.50)mm,respecti
8、vely.Conclusion:Apertureofsphenoidalsinusisanimportantmarkerinendosopictranssphenoidalsellasurge
