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目的通过解剖学研究,探讨内镜经鼻、上颌窦、翼突入路至Meckel囊区的解剖特点和方法,寻找手术入路中的重要解剖标志点,测量相关解剖数据,为内镜经鼻入路处理Meckel囊区病变提供解剖学依据。方法 5例共10侧新鲜成人头颅标本,采用内镜经鼻、上颌窦、翼突入路解剖和暴露Meckel囊区,寻找该手术入路中重要的解剖标志,研究具体的解剖方法,测量相关的解剖数据,解剖过程中使用导航。结果鼻小柱下缘至后鼻孔上缘为(66.5±3.3)mm,至蝶窦口下缘为(61.2±1.6)mm,至腭蝶管前口下缘为(64.6±1.4)mm,至蝶腭孔下缘为(62.8±2.3)mm,至翼管前口下缘的距离为(75.4±3.3)mm,翼管前口下缘与腭蝶管前口上缘距离为(2.1±0.7)mm,与圆孔下缘距离为(7.5±0.7)mm,腭蝶管长度为(6.4±0.5)mm,翼管长度为(13.3±1.2)mm。以腭蝶管为解剖标志可以寻找到翼管前口;以翼管为解剖标志可以寻找到岩骨段颈内动脉前膝部,以斜坡旁颈内动脉隆突可以寻找到斜坡旁颈内动脉,以圆孔可以寻找到上颌神经。导航能够准确定位上述解剖标志。结论运用内镜经鼻、上颌窦、翼突入路可以解剖和暴露Meckel囊区。此入路是由Meckel囊前方四边形区域暴露该区域,此四边形内侧为斜坡旁段颈内动脉,下方为岩骨段颈内动脉,上方为展神经,外侧方为上、下颌神经;实验数据和导航可以辅助定位重要的解剖结构和标志。
Objective To investigate the anatomical characteristics and methods of endoscopic nasal, maxillary and maxillary sinus approach to the Meckel capsule by anatomic study and to find important anatomical landmarks in the surgical approach and to measure the relevant anatomic data for endoscopic nasal Road treatment Meckel cystic lesions provide anatomical basis. Methods A total of 10 fresh adult skull specimens were obtained from 5 adult patients. The endoscopic, nasal, maxillary, and maxillary approach were used to dissect and expose the Meckel capsule. The anatomic landmarks of this approach were searched for specific anatomic landmarks, Anatomical data is used during navigation of the anatomy. Results The distance between the lower edge of the columella and the posterior nostril was (66.5 ± 3.3) mm, (61.2 ± 1.6) mm to the lower edge of the sphenoid sinus, and (64.6 ± 1.4) mm to the lower edge of the anterior orifice of the palatal butterfly The lower edge of the sphenopalatine foramen was (62.8 ± 2.3) mm, and the distance from the lower edge of the anterior fissure was (75.4 ± 3.3) mm. The distance between the lower edge of the sphenopalatine foramen and the upper edge of the front mouth of the palatal volar was (2.1 ± 0.7) mm, the distance from the lower edge of the circular hole was (7.5 ± 0.7) mm, the length of the palatine butterfly was (6.4 ± 0.5) mm and the length of the wing was (13.3 ± 1.2) mm. To the palatal butterfly as an anatomical landmark can be found to the wing before the mouth; to the wing as an anatomical landmark can be found in the petrous section of the internal carotid artery before the knee, with a slope next to the internal carotid artery carotid artery can be found to the slope of the internal carotid artery To the hole can be found to the maxillary nerve. Navigation can accurately locate the above anatomical landmarks. Conclusion The use of endoscopic nasal, maxillary sinus, wing approach can dissect and expose the Meckel capsule. This approach is exposed by the Meckel capsule in front of the quadrilateral region of the region, the quadrilateral side slope of the internal carotid artery, the lower part of the petrous section of the internal carotid artery, the top for the development of nerve, the lateral side of the upper and lower jaw nerve; experimental data and Navigation can aid in the positioning of important anatomical structures and signs.