摘要
目的通过对国人鼻泪管与上颌窦内侧壁的应用解剖,为鼻泪管及上颌窦病变的临床研究提供解剖学依据。方法对15例成人尸体标本的30侧鼻泪管与上颌窦内侧壁进行解剖,分别对鼻泪管、上颌窦内侧壁及两者间的结构进行观察和测量。结果骨性鼻泪管上端起于泪囊窝,斜向后内下方走行于上颌窦内侧壁前上1/4部,止于下鼻道外侧壁顶部前中1/3交界处,管内壁骨质最薄为(1.02±0.38)mm,管外壁骨质最薄为(0.62±0.50)mm;膜性鼻泪管管壁菲薄,上段被覆于骨性鼻泪管内,下段穿鼻腔黏膜进入下鼻甲深面。上颌窦窦口位于上颌窦内侧壁上1/3处并开口于中鼻道,窦口中心到上颌窦内侧壁上界的距离为(3.88±2.13)mm,窦口中心与骨性鼻泪管间垂直距离为(8.97±4.52)mm,窦口后下部常为中鼻道骨质最薄处,骨质厚度为(0.44±0.30)mm。下鼻道外侧壁中1/3处为骨质薄弱区,骨质厚度为(0.34±0.13)mm。结论鼻泪管外壁厚度总体小于内壁,经外壁与上颌窦连通可减少创伤;上颌窦窦口后下部骨质薄且远离鼻泪管,于此处行窦口扩张术易于施行且不易损伤鼻泪管;下鼻道外侧壁中1/3处为骨质薄弱区,是下鼻道开窗的最佳部位。
Objective To provide anatomical basis for the clinical study of nasolacrimal duct and maxillary sinus diseases through the applied anatomy of the inner wall of nasolacrimal duct and maxillary sinus in Chinese individuals.Methods The 30 nasolacrimal ducts from 15 adult cadaveric specimens and the inner wall of maxillary sinus were dissected.The structures of nasolacrimal duct,the inner wall of the maxillary sinus and the interconnections between them were observed and measured.Results The upper end of the bony nasolacrimal duct arose from the dacryocyst fossa and it walked diagonally backward,inward and downward in the anterior superior 1/4 bone wall of the inner wall of the maxillary sinus,and stopped at the anterior middle 1/3 junction of the top of the lateral wall of the lower nasal meatus,the thinnest bone of the inner wall of nasolacrimal duct was(1.02±0.38)mm,the thinnest bone of the lateral wall of nasolacrimal duct was(0.62±0.50)mm.The membranous nasolacrimal duct had a thin wall and the upper segment was covered by the bony nasolacrimal duct,the lower segment passed through the nasal mucosa into the deep surface of the inferior turbinate.The ostium of maxillary sinus was located at 1/3 of the inner wall of maxillary sinus and opened in the middle nasal meatus.The distance from the center of the ostium to the superior boundary of the inner wall of the maxillary sinus was(3.88±2.13)mm,the vertical distance between the center of the ostium and the bone nasolacrimal duct was(8.97±4.52)mm.The posterior lower part of the sinus ostium was usually the area with the thinnest bone in the middle nasal meatus,its bone thickness was(0.44±0.30)mm.The lateral wall of the inferior nasal meatus at the middle of 1/3 was the region with weak bone structure and its bone thickness was(0.34±0.13)mm.Conclusions The thickness of the lateral wall of the nasolacrimal duct is generally smaller than that of the inner wall.The connection to the maxillary sinus through the lateral wall can reduce the trauma.The posterior lower part of maxillary sinus has thin bone and is far away from nasolacrimal duct,so it is easy to perform sinus dilatation here without damaging nasolacrimal duct.The bone at the middle third of the lateral wall of the lower nasal meatus is thin,which is the best place for fenestration of the lower nasal meatus.
作者
张舒萱
邹迅
张洋华
王倩雅
周釜鹏
雍刘军
Zhang Shuxuan;Zou Xun;Zhang Yanghua;Wang Qianya;Zhou Fupeng;Yong Liujun(Chengdu Medical College,Chengdu 610500,Sichuan Province,China;Department of Human Anatomy,Chengdu Medical College,Chengdu 610500,Sichuan Province,China)
出处
《中国临床解剖学杂志》
北大核心
2025年第5期504-510,共7页
Chinese Journal of Clinical Anatomy
基金
2023年省级大学生创新创业训练项目(S202313705085)
四川省教育厅科研项目(17ZA0121)。
关键词
鼻泪管
上颌窦
应用解剖
Nasolacrimal duct
Maxillary sinus
Applied anatomy
