CT仿真内窥镜下上颌窦手术不同进路的探讨

发布时间：2018-03-16 11:19

  本文选题：CT仿真内窥镜　切入点：上颌窦　出处：《中国医科大学》2010年硕士论文　论文类型：学位论文

【摘要】： 目的 利用CT仿真内窥镜观察上颌窦手术各种入路下的视野范围,并通过测量及描述不同入路的视野范围,寻求不同手术入路联合,扩大手术视野,去除死角,彻底清除病变的方法,从而探讨CT仿真内窥镜在上颌窦手术中的临床应用价值。 材料和方法 选取3例成人尸头共6个上颌窦窦腔作为标本,清洁并冲净上颌窦窦腔后分别进行CT扫描,利用仿真内窥镜系统模拟0度鼻内镜,对标本进行三种上颌窦手术进路(经犬齿窝上颌窦前壁入路,经中鼻道入路,经下鼻道入路)的视野观察,确认并描述上颌窦手术各种入路下的视野范围,并找出不同标本上颌窦窦腔视野范围之间的区别。 结果 经标准上颌窦前壁开窗即柯陆氏入路的仿真内窥镜模拟0°鼻内镜检查：视野范围较大,可检查到整个后壁,大于1／2的内侧壁、外侧壁、顶壁及底壁,小于1／2的前壁。视野死角主要为临近开窗口的前壁以及小部分的内侧壁。对于气化不良的上颌窦腔,可窥清整个窦腔。中鼻道入路及下鼻道入路视野范围较局限,相互联合可扩大视野,可窥及大部分后壁,小部分的顶壁和外壁,前壁、底壁及内壁均无法窥及。 结论 不同形状的上颌窦窦腔在CT仿真内窥镜模拟0度鼻内镜下观察得到的视野范围具有差异性。CT仿真内窥镜具有无创性,能清晰地显示上颌窦窦腔结构,逼真地模拟鼻窦镜检查及手术,可以根据上颌窦窦腔的具体情况选择最佳的手术方案,使彻底清除上颌窦病变成为了可能,在鼻内镜下上颌窦手术领域有很好的应用价值及广阔的前景。
[Abstract]:Purpose. Using CT virtual endoscope to observe the range of visual field under various approaches of maxillary sinus surgery, and by measuring and describing the range of visual field of different approaches, seeking the combination of different operative approaches, expanding the operative field of vision and removing dead angle. To evaluate the clinical value of CT virtual endoscopy in maxillary sinus surgery. Materials and methods. A total of 6 maxillary sinuses were collected from 3 adult cadavers. After cleaning and cleaning the maxillary sinus cavity, CT scanning was performed respectively, and a virtual endoscope system was used to simulate 0 degree nasal endoscopy. The visual field of three kinds of maxillary sinus surgical approaches (anterior canine sinus approach, middle nasal approach, inferior nasal approach) were observed to confirm and describe the visual field of maxillary sinus surgery. The difference of the visual field of maxillary sinus cavity between different specimens was found out. Results. Virtual endoscopy through the standard maxillary antral wall fenestration, I. e., Calder's approach, simulated 0 掳nasal endoscopy: the visual field is large, the entire posterior wall can be detected, the medial wall, lateral wall, parietal wall and bottom wall are larger than 1/2. The dead angle of visual field is mainly the anterior wall adjacent to the open window and a small part of the medial wall. For the maxillary sinus cavity with poor gasification, the entire sinus cavity, the middle nasal approach and the inferior nasal approach are more limited. Combined with each other, the vision can be extended to most of the posterior wall, a small part of the apical wall and the outer wall, the anterior wall, the bottom wall and the inner wall can not be peered out. Conclusion. Different shapes of maxillary sinus cavity were observed under CT virtual endoscope under 0 degree nasal endoscopy. Ct virtual endoscopy was noninvasive and could clearly display the structure of maxillary sinus cavity. Realistic simulation of paranasal sinus examination and surgery, according to the specific conditions of the maxillary sinus cavity can choose the best surgical plan, so that the complete removal of maxillary sinus lesions became possible. It has good application value and broad prospect in the field of maxillary sinus surgery under nasal endoscope.
【学位授予单位】：中国医科大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R765.9
，

本文编号：1619686