三种鼻内镜手术径路暴露翼腭窝的解剖研究及其临床意义  

Anatomy Study and Its Clinical Significance of Three Kinds of Endoscopic Surgical Approach to Ptery- gopalatine Fossa

作　　者：刘海斌[1] 邓彬华[2] 彭浒[1] 彭渝[2] 刘环海[1] 万安云[2] 纪振华[1] 万锋[2] 朱秋蓓[1] 刘新[1] 周先伟[2] 廖建春[1] 

机构地区：[1]上海市第二军医大学附属长征医院耳鼻咽喉一头颈外科,200003 [2]武警江西总队医院耳鼻咽喉-头颈外科

出　　处：《解剖与临床》2013年第6期463-465,共3页Anatomy and Clinics

摘　　要：目的：研究三种鼻内镜手术径路暴露翼腭窝的解剖方法。方法：通过解剖成人尸体头部标本15例（30侧），采用手术显微镜及鼻内镜观察暴露翼腭窝的三种径路。结果：①中鼻道经腭术式可以暴露翼腭窝内侧的蝶腭动脉、腭神经、翼管神经，沿腭神经可确认翼腭神经节；②中鼻道经上颌窦术式能很好地暴露翼腭窝内、外侧壁，眶下神经是手术的重要标志；③下鼻甲切除经上颌窦术式比鼻内镜下中鼻道经上颌窦术式更广泛地暴露翼腭窝的内、外侧，提供宽阔的视野和较大的手术操作空间。结论：三种手术径路均能暴露翼腭窝的结构，具体术式需根据病变范围及手术要求而决定。Objective：To study the three kinds of endoscopic surgical approach to pterygopalatine fossa anatomy. Methods：To observe three pterygopalatine fossa exposure pathways by dissecting aduh cadaveric head specimens 15 cases （ 30 sides） and using endoscopy and surgical microscope. Results ： ①Medial fossa： spheno- palatine artery, palatine nerve, pterygoid canal nerve were exposed through the palate surgical approach, ptery- gopalatine ganglion along the palatine nerves could be confirmed. ②Pterygopalatine fossa, lateral wall of fossa could be exposed through the middle meatus after sinus surgical procedures. ③Surgical broader exposure to the pterygopalatine fossa, the lateral wall could be got through surgical nasal middle meatus after the inferior turbi- nate resection, which provided a broad vision and a larger operative space. Conclusions ：3 kinds of surgical ap- proach can expose the pterygopalatine fossa structures. Specific surgical decision depends on surgical require- ment and lesions.

关 键 词：显微解剖 翼腭窝 内镜手术入路 

分 类 号：R765.9[医药卫生—耳鼻咽喉科] R322.31[医药卫生—临床医学]