与鼻内镜上颌窦手术视野相关的上颌窦形态特征  

The maxillary sinus morphology that affect the vision of nasal endoscopy in maxillary sinus surgery

作　　者：刘婷婷[1] 董振辉[2] 张念凯[1] 李晶玉[1] 

机构地区：[1]青岛大学医学院附属医院耳鼻咽喉科,山东青岛266003 [2]青岛大学医学院附属医院重症医学科

出　　处：《临床耳鼻咽喉头颈外科杂志》2013年第23期1293-1295,共3页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:观察与鼻内镜上颌窦手术视野相关的上颌窦形态特征。方法:通过对1 000例(2 000侧)正常成人的鼻窦CT(轴位+冠状位)扫描,观察其上颌窦形态并进行分型。结果:CT显示上颌窦与手术相关的形态变化主要在其内侧壁,水平位鼻窦CT显示上颌窦内侧壁的形态在中部较恒定,一般都呈现以内侧壁为底边的三角形或半圆形,前者有857例(85.7%),后者有143例(14.3%);冠状位显示上颌窦内侧壁形态前、后层面较为恒定,中间层面的差异较大,有外凸形和平直形,其中外凸形341例(34.1%),平直形659例(65.9%)。根据中间层面内侧壁的形态及上颌窦气化程度将上颌窦形态分为三型:Ⅰ型662例(66.2%),Ⅱ型265例(26.5%),Ⅲ型73例(7.3%)。结论:上颌窦内侧壁形态影响鼻内镜中鼻道入路的上颌窦手术视野,在鼻内镜上颌窦手术前应充分考虑其形态对于手术视野及病变的清除的影响。Objective：To observe the gasification of the maxillary sinus which might affect the vision of the maxillary sinus surgery with endoscope. Method： The diameters of 2 000 maxillary sinus were observed and meas- ured by normal sinus CT scan. The maxillary sinus were then genotyped with the data. Result： Morphology of the medial wall of maxillary sinus played an important role in maxillary sinus surgery. According to the horizontal position CT data, the middle part of maxillary sinus medial wall included two shapes： 857 triangle （85.7＆）and 143 semicircular（14.3%）. According to the coronal CT data, the middle part of maxillary sinus medial wall varied a lot, there were also two shapes of them： 341 convex type（34.1%） and 659 straight type（65.9%）. In contrast, the former and back parts varied a little. Therefore, we genotyped the maxillary sinus according to the morphology of maxillary sinus medial wall and the gasification level. There were 3 types of our geno＇cyping： 662 of I type （66.2%）, 265 ofⅡ type （26.50%） ,73 of Ⅲ type（7.30%）. Conclusion：The medial wall of maxillary sinus should be considered before the surgery of nasal endoscopy because of the great affections of which to endoscopy vision.

关 键 词：上颌窦 鼻内镜 视野 形态 

分 类 号：R322.31[医药卫生—人体解剖和组织胚胎学]