鼻内镜手术相关的鼻腔鼻窦临床解剖研究

发布时间：2018-01-24 05:52

本文关键词： 鼻内镜鼻腔鼻窦解剖手术　出处：《山西医科大学》2010年硕士论文　论文类型：学位论文

【摘要】： 目的：通过尸头解剖,明确鼻腔主要解剖结构的位置、形态、变异、毗邻关系,探讨各结构在鼻内镜下诸多手术术式中的解剖学意义,为个性化手术方案的制定提供依据,同时制作一整套具有完全自主知识产权的鼻内镜手术相关的鼻腔解剖学图谱。方法：选取经10%甲醛溶液固定的成人尸头10具,干性头颅骨10例。按既定研究方法对尸头进行精细解剖研究,分析鼻腔及相关区域结构的位置、形态、毗邻关系。并用专业设备对鼻腔相关结构进行多方位拍摄。结果：明确了鼻内镜窦口鼻道复合体区域手术、额窦区域手术、鼻眼相关区域手术、蝶鞍区域、翼腭窝颞下窝区域手术相关解剖结构的详细形态、方位、界限及毗邻等。结论：1、钩突下端附着及囟门类型、钩突变异、筛泡及侧窦的气化类型、中鼻甲基板形态、泡甲、Haller气房是窦口鼻道复合体区域手术定位和谨慎操作的重要结构。2、在额窦区域手术中钩突上端附着、额隐窝形态、鼻丘气房、额隐窝区相关气房是影响手术操作的重要结构。3、明确上颌骨额突与泪骨的连接,鼻泪管走形及其与鼻丘气房的关系,纸样板、内直肌、视神经与筛窦、蝶窦的关系、视神经与眼动脉的走形关系对鼻眼相关手术有重要的指导意义。4、在经鼻蝶蝶鞍区域手术中,视神经-颈内动脉隐窝比视神经隆突或颈内动脉隆突的定位意义更显著,蝶鞍底壁凸面是蝶窦内定位中线的重要标志。同时,蝶窦外侧壁有颈内动脉,眼动脉,第2-6对脑神经经过,手术中应明确解剖结构,避免损伤导致相应的并发症。
[Abstract]:Objective: to determine the position, shape, variation and adjacent relationship of the main anatomical structure of nasal cavity by dissection of cadaveric head, and to explore the anatomical significance of each structure in many kinds of operations under nasal endoscope. To provide the basis for the establishment of individualized surgical scheme. At the same time, a complete set of nasal anatomy atlas of nasal endoscopic surgery was made. Methods: 10 adult cadavers fixed with 10% formaldehyde solution were selected. Ten cases of dry cranial bone were dissected according to the established research method to analyze the position and shape of nasal cavity and related regional structure. Contiguous relationship. Use professional equipment to take multi-directional photographs of nasal cavity-related structures. Results: the detailed morphology and orientation of the anatomical structures related to the surgery of the nasal endoscopic sinus ostioronasal complex region, frontal sinus region, nasal eye region, Sella region and pterygopalatine fossa inferior temporal fossa were identified. Boundaries and contiguity, etc. ConclusionThe type of attachment and fontanel to the lower end of uncinate process, the mutation of hook, the type of vaporization of ethmoid vesicles and lateral sinuses, the shape of basal plate of middle turbinate, the form of vesicular nail. Haller gas chamber is an important structure of surgical location and careful operation in the region of sinooronasal complex. It is attached to the upper end of the uncinate process, the shape of frontal recess, and the nasal colliculus gas chamber in frontal sinus surgery. The related gas chamber in the frontal recess area is an important structure affecting the operation. The connection between the maxillary frontal process and the lacrimal bone, the shape of the nasolacrimal duct and its relationship with the nasal colliculus chamber, the paper template, the medial rectus muscle, the optic nerve and the ethmoid sinus are defined. The relationship between sphenoid sinus, optic nerve and ophthalmic artery has important guiding significance for naso-ocular surgery. 4, in transsphenoidal Sella region surgery. The recess of the optic nerve and internal carotid artery is more significant than the optic nerve protuberance or the internal carotid artery protuberance is an important sign of the midline of the sphenoid sinus. At the same time the lateral wall of the sphenoid sinus has the internal carotid artery and the ophthalmic artery. The anatomic structure of 2-6 pairs of brain nerves should be clearly defined during operation to avoid the corresponding complications caused by injury.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R765

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