翼腭窝上颌窦进路的解剖学研究

发布时间：2018-01-08 05:06

本文关键词：翼腭窝上颌窦进路的解剖学研究　出处：《昆明医学院》2006年硕士论文　论文类型：学位论文

【摘要】：[目的]：通过对翼腭窝骨性标志和血管神经的测量为翼腭窝的手术提供形态学标志。 [方法]：在20个(40侧)干颅骨上对翼腭窝的重要结构(翼腭裂，蝶腭孔，翼管等)的形状，大小及毗邻结构进行测量。在10个(20侧)10％的福尔马林固定的成人尸体头颅标本进行模拟上颌窦入路进行解剖，测量相关的参数，然后对这些湿颅骨进行正中矢状切开，在手术显微镜下自正中向外侧打开上颌窦的内壁，翼腭窝的内壁，观察翼腭窝内三叉神经上颌支，上颌动脉的走行，进行上颌支的属支的测量。 [结果]：翼腭窝呈一狭长的漏斗型间隙，经八个自然管道与鼻腔，口腔，咽，眶，颞下窝，颅中窝相交通其主要内容物包括上颌动脉翼腭段及其分支，上颌神经及蝶腭神经节等。翼腭窝内组织分为的神经层，，血管层。 [结论]： 1 翼腭窝的解剖结构复杂，血管神经丰富，毗邻结构重要，熟知此区的显微解剖对手术治疗翼腭窝区的病变具有重要意义。 2 对于翼腭窝的病变可以采取上颌窦进路在打开上颌窦的后壁时可以以上颌窦的内壁顶壁和后壁三者的交点为解剖标志。用磨钻打开骨壁暴露翼腭窝。 3 手术时可以以圆孔和翼管为安全标志，建立起手术的安全界限。有助于保护重要结构，防止手术误入颅内。翼腭窝内的上颌动脉具有较多的变异，并且因人种不同有差异需要加以保护。 4 上颌窦进路具有暴露直观，副损伤小且避免颞侧进路损伤面神经的优点。
[Abstract]:[Objective: to provide morphological markers for the operation of pterygopalatine fossa by measuring the bone and blood vessels of pterygopalatine fossa. [Methods: the shape of the pterygopalatine fossa (pterygopalatine fissure, sphenopalatine foramen, pterygopalatine canal, etc. The size and adjacent structure were measured. 10% formalin fixed adult cadaveric head specimens were dissected by simulated maxillary sinus approach and related parameters were measured. Then the middle sagittal incision of these wet skulls was performed, and the inner wall of maxillary sinus and pterygopalatine fossa were opened from the middle to the lateral under the operating microscope, and the maxillary branches of the trigeminal nerve and the maxillary artery were observed in the pterygopalatine fossa. The branches of maxillary branches were measured. [Results: the pterygopalatine fossa presented a long narrow funnel space. Its main contents included the pterygopalatine segment of the maxillary artery and its branches through eight natural conduits, oral cavity, pharynx, orbit, infratemporal fossa and middle cranial fossa. Maxillary nerve and sphenopalatine ganglion, etc. The pterygopalatine fossa is divided into nerve layer and vascular layer. [Conclusion]: 1 the anatomical structure of pterygopalatine fossa is complex, the vascularity and nerve are abundant, and the adjacent structure is important. It is important to know the microanatomy of pterygopalatine fossa for surgical treatment. 2. For the lesion of pterygopalatine fossa, maxillary sinus approach can be used to open the posterior wall of maxillary sinus, which can be marked by the intersection of the top wall and posterior wall of the maxillary sinus, and to open the pterygopalatine fossa with grinding drill to expose the pterygopalatine fossa. 3The safe limit of operation can be established by using foramen and pterygoid canal as safety markers. It is helpful to protect the important structure and prevent the operation from entering the skull by mistake. The maxillary artery in pterygopalatine fossa has more variation. And different people have different species need to be protected. 4 maxillary sinus approach has the advantages of direct exposure, small collateral injury and avoiding injury of facial nerve via temporal approach.
【学位授予单位】：昆明医学院
【学位级别】：硕士
【学位授予年份】：2006
【分类号】：R322

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