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蝶窦疾病和外伤的外科治疗或通过蝶鞍环钻术切除垂体肿瘤时能否成功,在很大程度上取决于进入这些解剖结构的手术途径。尽管类似的外科操作已有很久的历史,许多学者仍然注意对其不断的改进。著者根据210例头骨和40具尸体的测量,认为通过鼻腔进入这些解剖结构较为合理,即首先在鼻入口部切开鼻中隔,分离鼻中隔粘膜时在软骨膜和骨膜下形成两个隧道样的通道,其中之一在鼻腔底,另一个在鼻腔穹窿。之后,在此二隧道内做两个直线形切口,切断方形软骨、垂直板、犁骨等;切口之一在鼻腔底,即沿着下部的隧道通路;另一个在鼻腔穹窿,沿着上部的隧道通路。结果使鼻中隔粘膜不破坏而鼻中隔本身成为活动的可移向一旁,形成手术的通道。切除蝶骨嘴,剖开蝶窦,取除蝶窦内粘膜,在良好的照明下并借助于鼻镜,可看到蝶窦穹
Surgical treatment of sphenoid sinus diseases and injuries, or successful resection of pituitary tumors by sella ring drilling largely depend on the surgical approach to these anatomical structures. Although similar surgical procedures have been around for a long time, many scholars still pay attention to their continuous improvement. Based on measurements of 210 skulls and 40 corpses, the author believes that it is reasonable to enter these anatomical structures through the nasal cavity. First, the nasal septum is cut at the nasal entrance. Two tunnel-like channels are formed beneath the perichondrium and periosteum when the nasal septum is separated. One of them is at the bottom of the nose and the other at the nasal cavity. After that, two linear incisions were made in the two tunnels to cut off the square cartilage, the vertical plate, the vault, and the like; one of the incisions was at the bottom of the nasal cavity, ie, the tunnel tunnel along the lower part; the other was in the nasal dome, Tunnel access. As a result, the mucosa of the nasal septum is not destroyed and the septum itself becomes movable to form a surgical access. Excision of sphenoid bone mouth, cut open the sphenoid sinus, remove the sphenoid mucosa, under good lighting and with the help of the nose, you can see the sphenoid sinus dome