钩突上端分叉时额隐窝引流途径及周边毗邻关系的CT观察  

CT observation of the drainage pathways of frontal recess and its adjacent structures with bifurcated superior portion of the uncinate process

作　　者：李珊 LI Shan(Department of Radiology,Traditional Chinese Medicine Hospital of China Three Gorges University,Yichang Hospital of Traditional Chinese Medicine,Hubei 443003,China)

机构地区：[1]三峡大学中医医院·宜昌市中医医院放射科,湖北443003

出　　处：《放射学实践》2020年第7期845-849,共5页Radiologic Practice

摘　　要：目的:观察当钩突上端分叉时额隐窝引流途径及周边毗邻关系,为更好的理解这一区域的解剖特征提供参考。方法:随机搜集本院行颅面部CT扫描的患者的影像资料,重建出鼻窦横轴面、冠状面及矢状面图像,观察当钩突上端为纸板-中鼻甲型、纸板-颅底型、纸板-颅底-中鼻甲型三种分叉类型时额隐窝的引流途径及周边毗邻关系。根据纳入和排除标准纳入134例钩突上端附着类型病例。结果:134例中,双侧钩突均呈分叉型71人,单侧分叉型63人,纸板-中鼻甲型106侧(51.7%),纸板-颅底型82侧(40%),纸板-颅底-中鼻甲型17侧(8.3%)。额隐窝引流共有四种途径:通过筛漏斗、下半月裂引流至中鼻道25.4%;通过钩突与中鼻甲之间直接引流至中鼻道26.3%;通过板间区引流至中鼻道46.8%;通过上半月裂引流至中鼻道1.5%。结论:当钩突上端分叉时,除了筛漏斗、直接中鼻道和上半月裂三种引流途径外,额隐窝还存在板间区这种引流途径。由于额隐窝区解剖的复杂性,充分认识其特征有助于提高鼻内镜额窦开放术的手术成功率。Objective:The purpose of this study was to observe the drainage pathways of frontal recess and its adjacent structures with bifurcated superior portion of the uncinate process,thus to provide a reference for better understanding the anatomical characteristics of this region.Methods:CT imaging data of patients with craniofacial CT scan was randomly collected.Axial,coronal and sagittal iamges of panarasal sinuses were reconstructed.The drainage pathways of frontal recess and adjacent structureal relationship were observed when the superior portion of the uncinate process was bifurcated and classified as lamina papyracea-middle turbinate type,lamina papyracea-skull base type and lamina papyracea-skull base-middle turbinate type.Results:In this group,lamina papyracea-middle turbinate type were 16 cases(51.7%);lamina papyracea-skull base type were 83 cases(40%);lamina papyracea-skull base-middle turbinate type were 17 cases(8.3%).There were four types of drainage pathways for frontal recess:drainage to middle nasal meatus through ethmoidal infundibulum and inferior semilunar hiatus 25.4%;drainage to middle nasal meatus between uncinate process and middle turbinate 26.3%;drainage to middle nasal meatus through the intermediate region of lamellas 46.8%;and drainage to middle nasal meatus through superior semilunar hiatus 1.5%.Conclusion:When the superior portion of the uncinate process is bifurcated,in addition to three drainage pathways of ethmoidal infundibulum-inferior semilunar hiatus,direct middle turbinate,and superior semilunar hiatus,the frontal recess can also be drained to middle nasal meatus through the intermediate region of lamellas.Because of the anatomical complexity of frontal recess region,fully understanding its characteristics will help to improve the success rate of endoscopic frontal sinus surgery.

关 键 词：钩突 额隐窝 额窦 内镜检查 

分 类 号：R814.42[医药卫生—影像医学与核医学]