腭鞘管后部的浅沟:定位腭鞘管的解剖标记  

The groove behind the palatovaginal canal: a landmark for identification of the palatovaginal canal

作　　者：孟庆国[1] 卢永田[1] 伍小六[2] 李建兴 孙焕吉[1] 张宝莹[1] 谢畅[1] 

机构地区：[1]深圳市第二人民医院耳鼻喉科,广东深圳518035 [2]深圳市第二人民医院放射科,广东深圳518035 [3]深圳市龙华新区中心医院耳鼻喉科,广东深圳518110

出　　处：《山东大学耳鼻喉眼学报》2015年第5期55-61,共7页Journal of Otolaryngology and Ophthalmology of Shandong University

基　　金：深圳市科技研发资金项目(JCYJ20130401113503369)

摘　　要：目的探讨腭鞘管后部的浅沟(以下简称后沟)在翼腭窝入路内镜手术及翼腭窝区域横断面CT中定位腭鞘管的解剖标记作用。方法选取20例颅骨标本,将探针置入腭鞘管以明确该管。在多层螺旋CT(MSCT)上观测腭鞘管及后沟并测量数据,并与传统方法定位腭鞘管的正确率比较。内镜下解剖颅骨和尸头的腭鞘管及后沟,进一步显示后沟的解剖标记作用。结果颅骨后沟的出现率为100%(40/40),腭鞘管后口附近为半管状,较浅者26侧,较深者14侧;前后外观呈细管状24侧,长椭圆形凹陷状16侧。影像学上腭鞘管与硬腭的夹角为(53.14±5.48)°,后沟与硬腭的夹角为(20.93±6.28)°,差异有统计学意义。后沟法对腭鞘管的定位准确率高于传统法,差异有统计学意义。结论内镜解剖、颅骨CT图像、CT横断面上两种定位腭鞘管方法对比显示了腭鞘管与后沟的解剖关系,提示后沟在经鼻翼腭窝入路内镜手术及翼腭窝区域横断面CT中帮助定位腭鞘管的优越性和解剖标记作用。Objective To explore the groove behind the palatovaginal canal （PVC）is a critical landmark for safe iden-tification of the PVC during endoscopic endonasal transpterygoid approaches and transfer CT scan of the pterygopalatine fossa.Methods Probes were inserted thorough the PVC of 20 dry skulls.The PVC and the groove behind it were proved on MSCT,meanwhile a comparative study was also carried out by the traditional method to identificate the PVC.Dissection of two skulls and cadaveric heads was performed to demonstrate the endoscopic anatomy of the PV canal and tbe groove.Results The grooves can be found in all 20 dry skulls and appeared as groof near the posterior opening of PV canal.26 sids were deep while 14 sides were dimple.Mainly appeared as tube-shaped （24 sides）or ovoid dimple-shaped （16 sides）.In CT scan,the average angle between PVS and the hard palate was 53.14 ＆#177;5.48＆#176;, while between the groove and the hard palate was 20.93 ＆#177;6.28＆#176;.There was also statistical difference for identification of the PVC in transfer CT between the traditional method and the method assisting with the groove.Anatomic steps and foundations for dissection of the PVC while using the groove as a landmark were described.Conclusion Anatomic in-vestigation,radiologic studies and comparison between the methods for identification of the PVC demonstrate the impor-tant anatomic relationship of the PVC with the groove,and reveal the groove as a landmark in endoscopic endonasal transpterygoid approaches and transfer CT scan of the pterygopalatine fossa.

关 键 词：腭鞘管 翼管 犁鞘管 腭鞘管后部浅沟 翼腭窝 鼻内镜检查 多层螺旋CT 

分 类 号：R762[医药卫生—耳鼻咽喉科]