100例尸头额隐窝气房正常变异及额窦引流通道分析方法  

Frontal recess classification and analysis of the frontal sinus passageway in 100 Chinese cadaver heads

作　　者：吴彦桥[1] 郑伟明 李九胜 WU Yanqiao;ZHENG Weiming;LI Jiusheng(Department of Otolaryngology Head and Neck Surgery, Bethune International Peace Hospital, Shijiazhuang 050000, Hebei, China;Department of Five Departments, Shijing People＇s Hospital, Baiyun District, Guangzhou 510430, Guangdong, China;People＇s Hospital of Yuci District, Jinzhong City, Shanxi Province, Yuci 030610, Shanxi, China)

机构地区：[1]白求恩国际和平医院耳鼻咽喉头颈外科,河北石家庄050000 [2]广州白云区石井人民医院五官科,广东广州510430 [3]晋中市榆次区人民医院耳鼻喉科,山西榆次030600

出　　处：《山东大学耳鼻喉眼学报》2018年第3期31-36,共6页Journal of Otolaryngology and Ophthalmology of Shandong University

摘　　要：目的探讨中国人额隐窝气房变异种类及额窦引流通道类型,指导鼻科医生安全开放额窦。方法 100例尸头标本行解剖前薄层轴位CT扫描,按照额隐窝气房分类及"搭积木"式额窦引流通道分析方法,分析额窦引流通道,并通过解剖得以证实。结果中国人额隐窝气房发育变异较大,包括前方外侧的鼻丘气房、鼻丘上气房、鼻丘上额气房;内侧的额窦间隔气房;后方的筛泡、筛泡上气房、筛泡上额气房;100例标本中,鼻丘气房发生率95%;鼻丘上气房发生率为32%;鼻丘上额气房发生率为19%;筛泡上气房发生率为53.5%;筛泡上额气房(额泡气房)发生率为22%;额窦间隔发生率为23.5%;额窦引流通道形式有多种,按出现情况,从多到少为:前内侧型(右侧34例,左侧35例);前方型(右侧18例,左侧17例);内侧型(右侧14例,左侧13例);前外侧型(右侧10例,左侧10例);后方型(右侧6例,左侧7例);外侧型(右侧6例,左侧5例);直接型(右侧3例,左侧5例);后内侧型(右侧3例,左侧4例);夹缝型(右侧2例,左侧0例);后外侧型(双侧均有1例)。结论采用额隐窝气房分类法,按照"搭积木"方式分析额窦引流通道,是一个"以不变应万变"的方法,可以帮助鼻科医生术前了解额窦引流通道形式,术中安全、彻底开放额窦。Objective To classify types of frontal recesses using Chinese cadaver heads, in order to simplify frontal recess classification and to allow easier and safer construction of the frontal sinus passageway for frontostomy. Methods A total of 100 Chinese cadaver heads underwent sliced sinus computed tomography scans. Data describing the frontal recess were summarized based on the International Frontal Sinus Anatomy Classification system. The frontal sinus passageway was analyzed and verified via cadaver dissection. Results The frontal sinus in Chinese cadaver heads exhibits very large variation in its composition. Cells were present in scans as follows： agger nasi cells in 95%; supra agger nasi cells in 26% of T1 scans, 6% of T2 scans; supra agger frontal cells in 19%; supra bulla cells in 53.5%; supra bulla frontal cells in 22%; and frontal septal cells in 23.5%. Agger nasi, supra agger, and supra agger frontal cells belong to the anterior frontal recess group; frontal septal cells belong to the medial frontal recess; supra bulla and supra bulla frontal cells belong to the posterior group. We classified the frontal sinus passageway into 10 types（in descending frequency）： anterior medial（right side, 34 cases; left side, 35 cases）; anterior（right side, 18 cases; left side, 17 cases）; medial（right side, 14 cases; left side, 13 cases）; anterior lateral（right side, 10 cases; left side, 10 cases）; posterior（right side, 6 cases; left side, 7 cases）; lateral（right side, 6 cases; left side, 5 cases）; direct（right side, 3 cases; left side, 5 cases）; posterior medial（right side, 3 cases; left side, 4 cases）; slit（right side, 2 cases; left side, 0 cases）; and posterior lateral（1 case for both sides）. Conclusion Use of the International Frontal Sinus Anatomy Classification and the three-dimensional frontal sinus passageway methods may help rhinologists easily construct frontal sinus passageways and safely perform frontostomy.

关 键 词：额窦 额隐窝 额窦引流通道 CT三维成像 

分 类 号：R765.4[医药卫生—耳鼻咽喉科]