筛动脉筛窦段的鼻内窥镜手术相关解剖  

APPLIED ANATOMY OF ETHMOIDAL ARTERY IN ETHMOID IN RELATION WITH ENDOSCOPIC SINUS SURGERY

作　　者：郎军添[1] 萧璧君[1] 范静平[1] 党瑞山[2] 纪荣明[2] 

机构地区：[1]第二军医大学附属长征医院耳鼻喉科,上海200003 [2]第二军医大学解剖学教研室

出　　处：《解剖学杂志》1999年第3期222-226,共5页Chinese Journal of Anatomy

摘　　要：目的 :研究筛动脉在筛窦内的走行特点 ,为减少鼻内窥镜手术并发症提供解剖指导。方法 :通过 30具湿性成人尸头 (男 19,女 11)的解剖 ,观测了筛动脉在筛窦段的走行部位、方向、骨管厚度及其与筛窦气房的关系。结果 :( 1)筛前动脉与中鼻甲基板的位置关系密切 ,多走行于中鼻甲基板之前的紧邻筛房顶 ( 66.6% )及中甲基板顶 ( 2 6.7% ) ;筛后动脉则以位于最后筛房顶最为多见 ( 64.9% ) ;( 2 )筛前、后动脉骨管的下壁明显薄于上壁 ( P<0 .0 1) ;( 3)部分筛前、后动脉骨管的下壁存在部分或全部的缺损 ;( 4 )过度气化的额窦或前筛气房的后 (下 )壁可取代前颅底成为筛动脉骨管的顶壁。结论 :上述解剖特点对于鼻内窥镜手术中避免筛动脉的损伤 。Objective: To study the anatomy of ethmoidal artery in the ethmoid and to provide instructions for endoscopic sinus surgery. Methods: 30 damp adult cadaveric heads (19 males, 11 females )were observed and measured to study the anatomic characteristics of the ethmoidal artery in the ethmoid, involving its course, location, osseous canal thickness and anatomic interrelationship with ethmoidal cells. Results: (1) Most of the anterior ethmoidal artery passed through the roof of the ethmoidal cell in front of the basal lamella (66.6%) or the basal lamella itself (26.7%). Most of the posterior ethmoid artery passed through the roof of the posterior ethmoidal cell(64.9%). (2)The osteal canal's lower wall of ethmoidal vessel was remarkably thinner than that of the upper wall (P<0.01). (3) There were bony defects on the canal's lower wall of the ethmoid artery. (4) The posterior (lower) wall of frontal sinus or anterior ethmoidal cells, which were excessively pnumetized, might act as the roof of the anterior ethmoidal artery instead of the floor of anterior skull fovea. Conclusion: The results provide valuable instructions for avoiding the injury of ethmoid vessels and eliminating the complication of hemorrhage in endoscopic sinus surgery.

关 键 词：筛前动脉 筛后动脉 筛窦 鼻内窥镜手术 解剖 

分 类 号：R322.31[医药卫生—人体解剖和组织胚胎学]