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目的使用三维高分辨率CT(HRCT)重建的方法,观察经鼻内镜至翼腭窝(PPF)的手术入路中的重要解剖结构,探讨翼管(VC)、圆孔(FR)和蝶腭孔(SPF)这些重要解剖标志的三维立体空间关系。方法回顾性分析17例患者及1例尸体标本的HRCT扫描数据。在CT三维重建的影像中,观察SPF、VC和FR的形态以及SPF和VC之间的三维立体空间关系。结果三维测量SPF,VC,和FR的平均直径分别为(6.26±1.59)mm,(2.35±0.77)mm和(2.75±0.77)mm。VC和SPF后下缘之间的平均距离为(4.03±1.15)mm。三维立体CT重建影像中VC和FR之间的平均垂直和水平距离分别为(4.94±1.35)mm和(9.22±3.07)mm。VC的全部或部分边缘92%(33/36)位于SPF的下缘以上,97%(35/36)位于SPF内缘外侧。结论深入理解SPF、VC和FR之间的三维空间立体关系,有助于安全实行内镜下经鼻至翼腭窝的手术。
Objective To observe the important anatomic structures of endoscopic approach to the pterygopalatine fossa (PPF) by three-dimensional high-resolution CT (HRCT) reconstruction and to explore the relationship between VC and FR, Palatal hole (SPF) these important anatomical landmarks of the three-dimensional spatial relationship. Methods Retrospective analysis of HRCT scan data of 17 patients and 1 corpse specimen. In CT three-dimensional reconstruction images, observe the morphologies of SPF, VC and FR as well as the three-dimensional spatial relationship between SPF and VC. Results The average diameters of SPF, VC and FR in three-dimensional measurement were (6.26 ± 1.59) mm, (2.35 ± 0.77) mm and (2.75 ± 0.77) mm, respectively. The average distance between the lower edge of VC and SPF was (4.03 ± 1.15) mm. The average vertical and horizontal distances between VC and FR in three-dimensional CT reconstruction images were (4.94 ± 1.35) mm and (9.22 ± 3.07) mm, respectively. Ninety-two percent (33/36) of all or part of the VCs were above the lower edge of the SPF and 97% (35/36) were outside the inner edge of the SPFs. Conclusion The deep understanding of the three-dimensional spatial relationship between SPF, VC and FR helps to safely perform endoscopic transnasal to pterygopalatine fossa surgery.