额窦引流通路的薄层断面解剖及其在额窦手术中的意义

发布时间：2018-05-19 07:17

本文选题：引流通路 + 额隐窝　；参考：《山东大学》2007年硕士论文

【摘要】： 研究目的：应用鼻腔额窦的薄层断面解剖图像，追踪额窦引流通路，观察解剖通路上的各主要结构，并测量与额窦手术有关的鼻丘气房、钩突等结构的相关数据，，为额窦的鼻丘径路手术及钩突径路等手术提供解剖学依据，并探讨额窦的薄层断面解剖图像在额窦手术中的意义。研究方法：通过冰冻铣切技术获得鼻部连续断面图像，不同层面上观察额窦的解剖边界及引流通路，测量鼻丘气房横径、垂直径、前后径，鼻丘最前气房前壁厚度，鼻丘气房前壁中点到中鼻甲前端根部的距离，钩突的高度，钩突中段的厚度，钩突水平段根部的厚度，与钩突根部连接处的鼻泪管内侧壁的厚度，钩突的内倾角，筛泡与钩突之间的距离，筛泡的骨壁厚度，筛泡的最大内外径，筛泡的最大垂直径等数据。结果：额隐窝为一复杂的三维空间结构，鼻丘横径为(6.78±1.22)mm，垂直径为(10.86±2.21)mm，前后径为(8.19±1.23)mm，鼻丘气房前壁厚度为(0.47±0.09)mm，鼻丘气房前壁中点到中鼻甲前端根部的距离为(7.12±0.74)mm，钩突的高度为(6.86±2.46)mm，钩突中段的厚度为(1.12±0.15)mm，钩突水平段根部的厚度为(1.27±0.22)mm，与钩突根部连接处的鼻泪管内侧壁的厚度为(1.71±0.08)mm，钩突的内倾角为(116.8±20.6)°，筛泡与钩突之间的距离为(6.86±0.24)mm，筛泡的骨壁厚度为(0.26±0.12)mm，筛泡的最大内外径为(9.62±2.26)mm，筛泡的最大垂直径为(12.93±6.89)mm。结论：了解额窦引流通路解剖对于手术的成功非常重要，钩突和鼻丘及其同周边结构的解剖关系结合起来考虑即能做到术中准确定位，对鼻丘气房及钩突的观察及测量可为额窦手术提供解剖学指导，使用薄层断面解剖图像研究解剖结构及解剖关系可以获得较为精确的鼻丘气房前壁及钩突等重要结构的相关数据。
[Abstract]:Objective: to observe the main structures of frontal sinus drainage pathway by using thin sectional anatomical images of nasal cavity and frontal sinus, and to measure the relevant data of nasal colliculus, uncinate process and other structures related to frontal sinus surgery. To provide anatomic basis for the operation of the nasal colliculus approach and uncinate process approach of the frontal sinus, and to explore the significance of thin sectional anatomy images of the frontal sinus in the operation of the frontal sinus. Methods: the continuous sectional images of nasal region were obtained by freezing milling technique. The anatomic boundary and drainage path of frontal sinus were observed on different levels. The transverse diameter, vertical diameter, anteroposterior diameter, anterior wall thickness of anterior chamber of nasal colliculus were measured. The distance from the midpoint of the anterior wall of the nasal colliculus to the root of the anterior part of the middle turbinate, the height of the uncinate process, the thickness of the middle segment of the uncinate process, the thickness of the root of the horizontal segment of the uncinate process, the thickness of the medial wall of the nasolacrimal duct connected with the root of the uncinate process, the angle of internal inclination of the uncinate process, The distance between ethmoid vesicle and uncinate process, the thickness of bone wall of ethmoid bubble, the maximum inner and outer diameter of ethmoid bubble, the maximum vertical diameter of ethmoid bubble, etc. Results: the frontal recess is a complex three-dimensional structure. The transverse diameter of nasal colliculus is 6.78 卤1.22 mm, the vertical diameter is 10.86 卤2.21 mm, the anteroposterior diameter is 8.19 卤1.23 mm, the thickness of anterior wall of nasal colliculus is 0.47 卤0.09 mm, the distance from the midpoint of anterior wall of nasal colliculus to the anterior root of middle turbinate is 7.12 卤0.74 mm, the height of uncinate process is 6.86 卤2.46 mm, the thickness of middle segment of uncinate process is 1.12 卤0.15 mm, and the horizontal segment of uncinate process is horizontal segment. The thickness was 1.27 卤0.22 mm, the thickness of medial wall of nasolacrimal duct was 1.71 卤0.08 mm, the angle of internal inclination of uncinate process was 116.8 卤20.6 掳, the distance between ethmoid vesicle and uncinate process was 6.86 卤0.24 mm, the thickness of bone wall of ethmoid vesicle was 0.26 卤0.12 mm, the maximum inner and outer diameter of ethmoid vesicle was 9.62 卤2.26 mm, and the maximum vertical diameter of ethmoid vesicle was 12.93 卤6.89 mm 路mm. Conclusion: it is very important to understand the anatomy of frontal sinus drainage pathway for the success of the operation. Considering the anatomic relationship between the uncinate process and the nasal colliculus and its surrounding structure, the accurate localization can be achieved during the operation. The observation and measurement of the gas chamber and uncinate process of the nasal colliculus can provide anatomical guidance for frontal sinus surgery. Using thin sectional anatomical images to study the anatomical structure and anatomical relationship, we can obtain more accurate data of the important structures such as the anterior wall of the nasal colliculus and the uncinate process.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2007
【分类号】：R322.31;R765

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