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1、局解手术学杂志2004年第13卷第5期292JRegionalAnat&OperativeSurg,2004,Vol.13,No.5蝶腭孔、翼管前口的应用解剖及临床意义12322彭大才,李振强,杨伟斌,孙建森,姚远(1.重庆医科大学应用技术学院解剖学教研室,重庆400050;2.第三军医大学解剖学教研室,重庆400038;3.重庆市卫生学校基础教研室,重庆400050)[摘要]目的为鼻内窥镜翼管神经切断术等临床应用提供解剖学依据。方法用15个30侧经防腐处理的成人头颅标本,经正中矢状面剖开,解剖观察测量蝶腭孔、翼管前口及穿过的血管、神经。结果19例(63.3
2、3%)蝶腭孔位于中鼻甲后端前方平均8.09mm;11例(36.67%)位于在中鼻甲后端前上方平均7.24mm。蝶腭孔呈圆形24例,直径平均3.25mm;呈卵圆形6例,最大径平均4.92mm。穿过蝶腭孔的动脉有蝶腭动脉,或其分支鼻后外侧动脉和鼻中隔后动脉。翼管前口位于蝶腭孔后方约7mm,呈圆形漏斗状,横径约3mm,略向外下方开口,距离鼻小柱平均71.72mm,有翼管神经和翼管动脉穿过。结论经鼻腔暴露翼管前口及翼管神经,以及进入翼腭窝处理上颌动脉末端的分支时,蝶腭孔及其周围骨质菲薄的部位是理想的手术入路部位。[关键词]蝶腭孔;翼管;翼管神经;应用解剖[中图分类号
3、]R323[文献标识码]A[文章编号]1672-5042(2004)05-0292-03AppliedanatomyandclinicalsignificanceofthesphenopalatineforamenandtheanterioropeningofthepterygoidcanalPENGDa-cai,LIZhen-qiang,YANGWei-bin,SUNJian-sen,YAOYuan(DepartmentofAnatomy,AppliedTechnicalCollege,ChongqingUniversityofMedicalScience
4、s,Chongqing400050,China)Abstract:ObjectiveToprovidetheanatomicalbasisforthevidianneurotomybytheendonasalendoscopy.MethodsThesphenopalatineforamenandtheanterioropeningofthepterygoidcanalon30sidesformalin-preservedmidsagittaladultheadspecimensweredissectedandobserved.ResultsThespheno
5、palatineforamenlocatedontheanterioroftheposteriorendofthemiddleconchawasfoundin19sides,andthespacingbe-tweenthemwasabout8mm.Thesphenopalatineforamenlocatedontheanterosuperiorsideofthesphenopalatineforamenwasfoundin11sides,andthespacingbetweenthemwasabout7mm.Sphenopalatineforamenwit
6、hroundshapewasfoundin24cases,andtheaveragediameterwas3.25mm,butoval-shapedsphenopalatineforamenwasfoundinothercases,andthemaximaldiameterwasaveraged4.29mm.Thearteriesgoingstraightthroughthesphenopalatineforamenwerethesphenopalatinearteryoritsbranches.Theanterioropeningofthepterygoi
7、dcanalwaslocatedbehindthesphenopalatineforamenandhadaroundinfundibularshape.Theopeningswereabout3mminthetransversediameterandpassedthroughbythevid-iannerveandthepterygoidartery.ConclusionThesphenopalatineforamenandtheareaaroundtheforamenwithverythinbonyplatearetheidealoperativegrou
8、te,throughwhichsomeclinica
