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[目的]探讨旁中线颅底鼻内镜手术入路及其应用解剖学.[方法]对60具成人鼻颅底CT用交互式医学影像控制软件进行三维重建,在三维重建的模型上可以进行颅底的相关结构测量.对20具湿性头颅标本行鼻内镜下旁中线颅底解剖.联合鼻腔-上颌窦入路研究颞下窝、翼腭窝以及鼻咽部的重要神经血管、肌肉以及骨性解剖标志等旁中线颅底重要解剖结构.[结果]颈静脉孔内缘、翼管后端、颈动脉管外口内缘、破裂孔内缘到中线的距离分别为(28.67±1.50)mm、(13.2±1.37)mm、(28.99±1.73)mm、(11.59±0.96)mm;上前鼻棘到破裂孔的距离为(72.68±2.43)mm;犁骨后缘中点到破裂孔的距离为(13.71±1.14)mm.[结论]鼻内镜下联合鼻腔-上颌窦入路研究翼腭窝、颞下窝、鼻咽咽鼓管区等旁中线颅底解剖,具有更加广阔的视觉空间和手术空间,是临床治疗中值得推广的一个较佳的手术方法.“,”[Objective]TostudytheapproachandappLiedanatomyoftheparanasaLendoscopiccranioscopiaL endoscopicsurgery.[Methods]SixtyaduLtnasaLandskuLLbaseCTscanswerereconstructedbyinteractivemedicaL imagecontroLsoftware.ThereLatedskuLLbasestructurescouLdbemeasuredonthethree-dimensionaLreconstructed modeL.20wetskuLLspecimensweredissectedonthemidLineskuLLbaseundernasaLendoscopy.Combinedwithna-saL-maxiLLarysinusapproach,theimportantanatomicaLstructuresoftheparamedianskuLLbase,suchastheinfra-temporaLfossa,pterygopaLatinefossaandtheimportantnervevesseLs,muscLesandbonyanatomicaLLandmarksof thenasopharynx,werestudied.[ResuLts]ThedistancesfromtheinnermarginofjuguLarforamen,theposterior endofpterygoidcanaL,theinnermarginofexternaLcarotidcanaLandtheinnermarginofrupturedforamentothe medianLinewere(28.67±1.50)mm,(13.2±1.37)mm,(28.99±1.73)mm,(11.59±0.96)mm,respectiveLy;thedistancesfromthesuperioranteriornasaLspinetotherupturedforamenwere (72.68±2.43)mm);thedis-tancefromthemidpointoftheposteriormarginofvomeruLatotherupturehoLewas(13.71±1.14)mm.[ConcLu-sion]AnatomyresearchonthepterygopaLatinefossa,infratemporaLfossa,nasopharyngeaLeustachiantubeareaand otherparamedianskuLLbaseundernasaLendoscopycombined withnasaLcavity-maxiLLarysinusapproachhasa broadervisuaLspaceandsurgicaLspace,isabettersurgicaLmethodworthyofpromotionincLinicaLtreatment.