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目的研究翼腭窝鼻内镜下临床解剖,为内镜下翼腭窝手术提供解剖学依据。方法10例(20侧)中国成人干性颅骨,用0°、25°Wolfe鼻内镜,在监视器下,分别从翼上颌裂、鼻腔以及底部不同角度观察翼腭窝结构。结果翼腭窝是一狭窄裂隙,由蝶骨体、蝶骨翼突和腭骨垂直板、上颌窦后壁共同围成,大小为(21.4±0.8)mm×(5.2±0.3)mm×(3.2±0.3)mm,从上面观察似三棱锥体型,上宽下窄。鼻内镜从翼上颌裂置入翼腭窝,可以观察到翼腭窝顶部眶下裂与位于其外侧3mm的圆孔,向下可见翼腭窝底部腭大孔与腭小孔。将鼻内镜置入鼻腔观察,咬除上颌窦骨性开口后方腭骨垂直部骨质并咬除上颌窦后内侧骨壁,0°鼻内镜可以窥及整个翼腭窝以及后壁全貌,后壁呈上宽下窄的梯形,见其内下方之翼管开口以及外上角之圆孔,二者之间有一明显的纵形骨嵴分隔。结论经鼻内镜下去除上颌窦口后部骨质以及部分上颌窦后内侧壁,可以完整显露整个翼腭窝的结构,表明翼腭窝范围的疾病可以采用鼻内镜处理。
Objective To study the clinical anatomy of the pterygopalatine fossa by endoscopic sinus surgery and to provide anatomic evidence for the operation of the pterygopalatine fossa under endoscopy. Methods Ten adult Chinese skulls (20 sides) were treated with 0 ° and 25 ° Wolfe endoscope. The structures of the pterygopalatine fossa were observed under the monitor from different angles of maxillary cleft, nasal cavity and bottom. Results The pterygopalatine fossa was a narrow fissure, which consisted of the sphenoid body, the sphenoid wing, the vertical plate of the palatal bone and the posterior wall of the maxillary sinus with a size of (21.4 ± 0.8) mm × (5.2 ± 0.3) mm × (3.2 ± 0.3) mm, looks like a pyramid from the top, narrowing up and down. Nasal endoscope was placed into the pterygopalatine fossa from the maxillary cleft of the wing. The foramen ovale at the top of the pterygopalatine fossa and the 3 mm round hole were observed at the top of the pterygopalatine fossa. Nasal endoscopy into the nasal cavity, bite in addition to maxillary sinus bony opening of the posterior phalangeal bone and bite in addition to the maxillary sinus medial bone wall, 0 ° nasal endoscopy can see the entire pterygopalatine fossa and the posterior wall of the whole picture, The rear wall was wide trapezoidal trapezoid, see the inner bottom of the wing opening and the outer corner of the round hole, there is a clear longitudinal separation between the two. Conclusion Endoscopic removal of the posterior part of the maxillary sinus ostium and the posterior medial wall of the maxillary sinus can completely reveal the structure of the entire pterygopalatine fossa, indicating that the disease in the pterygopalatine fossa can be treated by endoscopic sinus surgery.