摘要
目的为临床开展鼻内镜下上颌窦及经上颌窦翼腭窝或海绵窦手术提供上颌窦裂孔区解剖学数据。方法收集骨性鼻腔外侧壁保存完好的成人颅骨69具,鼻内镜下确定上颌窦裂孔大体标志和主要结构,测量前鼻嵴至上颌窦裂孔前缘的最上、中、下三点距离,以及前鼻嵴与上颌窦裂孔前缘最上、下两处连线与以鼻底作为水平线的夹角。根据上颌窦裂孔的解剖参数,自行设计出上颌窦盥洗针头并应用于鼻内镜下鼻窦开放术后系统随访,随访过程中使用上颌窦盥洗针头进行鼻窦盥洗,并进行鼻内镜检查,完成系统随访6个月后判断治疗效果。结果右侧前鼻嵴至上颌窦裂孔前缘的最上、中、下三点距离分别为（3.016±0.228）、（2.753±0.311）、（3.031±0.298）mm,左侧为（2.976±0.264）、（2.849±0.216）、（3.036±0.277）mm;前鼻嵴与上颌窦裂孔前缘最上、下两处连线与以鼻底作为水平线的右侧和左侧的夹角分别为（50.000±9.058）°、（39.078±9.541）°,（49.670±8.345）°、（40.980±8.709）°,左右侧距离及夹角比较,差异无统计学意义（P〉0.05）。上颌窦盥洗针头尺寸和大小、角度均有较好的设计,系统随访发现：使用上颌窦盥洗针头结合鼻内镜检查的随访技术,为鼻内镜下鼻窦手术的愈后带来良好效果。结论鼻内镜下前鼻嵴至上颌窦裂孔前缘的距离约3 cm,前鼻嵴与上颌窦裂孔前缘最上、下两处连线与鼻底水平线的夹角30°~60°。上颌窦盥洗针头的应用结合鼻内镜下鼻窦术腔的微处理模式能对鼻窦炎、鼻息肉的预后产生理想效果。
Objective To provite anatomic data for clinical research in pterygomaxillary fossa surgery and cavernous si- nus surgery via maxillary hiatus under nasal endoscope （NES）. Methods 69 cases of adult skull sample with the lateral wall of bony nasal cavity undamaged were selected, maxillary hiatus and surrounding primary configuration was definit- ed under nasal endoscope, the lengths between the anterior nasal crista and the superior, middle and the inferior point of the frontal edge of maxillary hiatus,and the included angles between the horizonal line of the nasal floor and the line between the anterior nasal crista and the superior, the inferior point of the frontal edge of maxillary hiatus were mea- sured under nasal endoscope and recorded at the same time. Based on the anatomic parameters of the maxillary hiatus on the adult skull samples, a self-created sinus-washing needles （SSN） was created and applied on the washing discharges of the maxillary sinus, nasal endoscope examination was given during the period of post-operative follow-up 6 months, after the follow-up,the therapeutic effect were recorded. Results The length of the right side between the anterior nasal crista and the superior, middle and the inferior point of the frontal edge of maxillary hiatus were （3.016±0.228）, （2.753±0.311）, （3.031±0.298） mm, andleft side were （2.976±0.264）, （2.849±0.216）, （3.036±0.277） mm; the right side included angle between the horizonal line of the nasal floor and the line between the anterior nasal erista and the superior hiatus were （50.000±9.058）°, （39.078± 9.541）°; the left side were （49.670±8.345）°, （40.980±8.709）°. these of right side were compared with those of the left side, the difference was not statistically significant （P 〉 0.05）. The therapy model of the SSN washing combined with the examination under NES showed it was very helpful to the prognosis of chronic sinusitis and nasal polps by system- atic follow-up after nasal endoscopic surgery. Conclusion The lengths between the anterior nasal crista and the supe- rior, middle and the inferior point of the frontal edge of maxillary hiatus measured under nasal endoscope is about 3 cm, and the included angles between the horizonal line of the nasal floor and the line between the anterior nasal crista and the superior, the inferior point of the frontal edge of maxillary hiatus are between 30° and 60°. During the period of fol- low-up, with the aid of transnasal endoscopic mini-handling as early as possible ,SSN is an effective method to facilitate the epithelization of nasal mucosa, and is helpful to preserve the natural outflow tract of sinuses. In our opinion, the therapy model of SSN conbined with micro-dissection under NES indicates a fine prognosis to the patients suffered by chronic sinussitis and nasal polps after endoscopic sinus surgery.
出处
《中国医药导报》
CAS
2014年第27期155-158,共4页
China Medical Herald
基金
广西壮族自治区卫生厅科研课题(编号Z2010051)
关键词
颅骨
钩突
鼻内镜
上颌窦裂孔
Skull
Uncinate process
Nasal endoscope
Maxillary hiatus
