经单鼻孔—蝶窦入路的解剖学研究

发布时间：2018-03-17 16:18

本文选题：经鼻蝶入路　切入点：经单鼻孔直接入路　出处：《福建医科大学》2006年硕士论文　论文类型：学位论文

【摘要】： 目的:通过在显微镜下对尸体头颅的解剖、测量,明确单鼻孔经蝶入路手术通道上相关结构的解剖关系。并对高度个体化的骨性结构、神经、血管等的解剖关系进行分析统计,取得国人此方面的资料。同期,收集16螺旋CT头部扫描图像,对入路相关结构进行三维重建及仿真内窥镜重建。旨在为单鼻孔经蝶入路提供重要的显微解剖及影像解剖参数。方法:用15例(30侧)成人头颅标本及20侧(40侧)成人骨性标本,模拟手术角度,在手术显微镜下对鼻、鼻中隔、蝶窦开口前区、蝶腭动脉及垂体窝周围的结构等进行直接解剖、观察和测量,同时行显微摄像。收集经16层螺旋CT头部薄层成像检查病人12例,将受检者的扫描原始数据进行横断面重建,然后将数据传送至ADW4.1高级工作站,分别对上述相位窗的横断面图像进行容积再现、多平面重建、仿真内窥镜以及曲面重建,重建鼻中隔、蝶窦开口前区、蝶腭孔、蝶腭动脉、蝶窦等结构的三维及仿真内镜图像,并对相关结构进行测量分析。结果: 一、标本解剖 1、鼻孔长径11.32±0.82(10.2~13.2)mm,鼻孔短径7.85±1.21(5.2~9.8)mm。鼻中隔厚度在前、中、后部分别为5.02±0.42(3.8~5.4)mm、5.57±0.47(4.5~6.4)mm、5.55±0.55(4.8~6.4) mm。 2、鼻中隔骨与软骨交界处距前鼻棘21.26±2.47(18.1~27.6)mm,距鼻孔内侧缘中点33.72±3.52(27.1~40.6)mm,距鼻小柱30.12±2.84(26.9~36.8)mm,距蝶窦口下缘38.04±3.49(32.4~45.1)mm,距后鼻孔41.82±3.96(36.9~50.1)mm。四方软骨中部厚度、边缘厚度、前后径、上下径分别为:1.12±0.13(0.92~1.42)mm、1.28±0.24 (0.83~1.67)mm、30.93±4.52(24.9~40.6)mm、29.94±2.14(24.8~34.3)mm。 3、蝶窦口长5.64±0.39(4.92~5.94)mm,宽3.58±0.22(3.10~3.96)mm,距上鼻甲尾部9.5±0.9(8.5~12.1)mm,距上鼻道未端14.5±1.1(12.5~16.4)mm,距中鼻甲尾
[Abstract]:Objective: to determine the anatomical relationship of the related structures in the single nostril transsphenoidal approach by microscopically dissecting and measuring the cadaveric heads, and to analyze and analyze the anatomical relationships of the highly individualized bone structures, nerves and blood vessels. At the same time, 16 helical CT head scanning images were collected to reconstruct the related structures of the approach and virtual endoscope. The purpose of this study was to provide important anatomical and imaging anatomical parameters for the transsphenoidal approach of single nostril. Methods: 15 adult skull specimens (30 sides) and 20 adult bone specimens (40 sides) were used to simulate the operation angle, and the nasal, nasal septum and anterior sphenoid sinus orifice were examined under the microscope. The structures of the sphenopalatine artery and the surrounding pituitary fossa were dissected, observed and measured, and microimaging was performed. Then the data were transferred to the ADW4.1 advanced workstation, and the volume reconstruction, multi-plane reconstruction, virtual endoscope and curved surface reconstruction of the transect images of the above phase windows were carried out, respectively, to reconstruct the nasal septum, the anterior region of the sphenoid sinus, the sphenopalatine foramen, the sphenopalatine artery. Three-dimensional and virtual endoscopy images of sphenoid sinus isospheres were measured and analyzed. Results:. I. Anatomy of specimens. 1.The length diameter of nostril was 11.32 卤0.82 卤0.82 卤13.2mm, and the short diameter of nostril was 7.85 卤1.215.2c9.8mmm. the thickness of nasal septum was 5.02 卤0.42n3.85.4mm ~ 5.57 卤0.474.56.4mm ~ 5.55 卤0.554.8mm ~ 6.4mm respectively. 2, the junction of nasal septum bone and cartilage is 21.26 卤2.47 ~ 18.1n 18.127.6mm from anterior nasal spine, 33.72 卤3.52 ~ 27.1m from the middle point of the medial margin of the nasal foramen, 30.12 卤2.84 ~ 26.9m ~ 36.8mm from the nasal column, 38.04 卤3.49m ~ 32.45.1mm from the inferior margin of sphenoid sinus, 41.82 卤3.9636.9m ~ 50.1 mm from the posterior nostril, 1.12 卤0.130.921.42mm ~ (1.28 卤0.24) mm ~ (1.28 卤0.24) 卤0.24 mm ~ (-1) mm ~ (?) ~ (30.93 卤54.224.94mm) 卤2.1424.4mm ~ (th) ~ (24) ~ (th) ~ (th) of the quadrilateral cartilage, the thickness of the margin, the diameter of the upper and lower sides are respectively 1.12 卤0.130.92142mm ~ 1.28 卤0.24 卤0.34. 3, sphenoid sinus orifice 5.64 卤0.39 ~ 4.92 ~ 5.94 mm long, 3.58 卤0.22 ~ 3.10 ~ 3.10 ~ 3.96 mm wide, 9.5 卤0.9 ~ 8.5 ~ 12.5 ~ 12.1mm from the tail of the superior turbinate, 14.5 卤1.1 ~ 12.5 ~ 16.4mm from the end of the superior nasal canal, and 16.4 mm from the middle turbinate tail.
【学位授予单位】：福建医科大学
【学位级别】：硕士
【学位授予年份】：2006
【分类号】：R322

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