翼管神经切断术相关解剖参数的影像学研究  

Imaging study of anatomical parameters related to pterygoid canal neurotomy

作　　者：蒋晓文 吴灵捷 赵可庆 JIANG Xiaowen;WU Lingjie;ZHAO Keqing(Department of Otolaryngology,Eye&ENT Hospital,Fudan University,Shanghai,200031,China)

机构地区：[1]复旦大学附属眼耳鼻喉科医院耳鼻咽喉科,上海200031 [2]华中科技大学协和深圳医院耳鼻咽喉科,广东深圳518000

出　　处：《临床耳鼻咽喉头颈外科杂志》2023年第2期141-143,共3页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：上海市“科技创新行动计划”自然科学基金项目(No:20ZR1410000);复旦大学附属眼耳鼻喉科医院“双优”临床实验资助计划(No:SYB202009)。

摘　　要：目的:通过测量翼管神经切断术中涉及到的重要解剖参数辅助术中精确定位翼管神经、预防手术并发症的发生。方法:对50例(100侧)慢性鼻窦炎、鼻窦囊肿、变应性鼻炎等疾病患者进行高分辨率CT(HRCT)检查,测量其腭鞘管后口至腭骨蝶突上缘中点、腭骨蝶突上缘中点至翼管外口、翼管外口至腭大管以及翼管外口至圆孔之间距离。结果:腭鞘管后口、腭骨蝶突上缘、翼管外口、腭大管和圆孔在定位翼管神经、预防并发症发生方面具有重要价值,腭鞘管后口至腭骨蝶突上缘,腭骨蝶突上缘至翼管外口,翼管外口至腭大管,翼管外口至圆孔的距离分别为(12.46±1.19) mm,(3.23±0.36) mm,(6.09±0.75) mm,(7.6±1.16) mm。结论:HRCT可作为术前定位翼管神经外口及其相关重要解剖标志距离的有利工具,术前所获距离参数对术中定位翼管神经及预防并发症具有指导价值。Objective:Measuring the important anatomic parameters related to vidian neurectomy to locate the vidian nerve accurately and prevent the surgical complications.Methods:High resolution CT(HRCT) was used to measure the distance parameters between the important anatomic landmarks in 50 patients(100 sides) with chronic rhinosinusitis,sinus cyst or allergic rhinitis et al.The distance from the posterior opening of the palatovaginal canal to the upper edge of the sphenoidal process of palatine bone,the upper edge of the sphenoidal process of palatine bone to the external opening of the vidian canal,the external opening of the vidian canal to the greater palatine canal,and the external opening of the vidian canal to the foramen rotundus were measured.Results:The posterior opening of the palatovaginal canal,the upper edge of the sphenoidal process of palatine bone,the external opening of the vidian canal,the greater palatine canal,and the foramen rotundum are of great value in locating vidain nerve and preventing surgical complications.The distance from the posterior opening of the palatovaginal canal to the upper edge of the sphenoidal process of palatine bone,the upper edge of the sphenoidal process of palatine bone to the external opening of the vidian canal,the external opening of the vidian canal to the greater palatine canal,and the external opening of the vidian canal to the foramen rotundus were(12.46±1.19) mm,(3.23±0.36) mm,(6.09±0.75) mm and(7.6±1.16) mm respectively.Conclusion:HRCT can be used as a powerful tool for preoperative localization of the external pterygoid nerve orifice and its related important anatomical landmarks,and the preoperative distance parameters obtained are valuable for intraoperative localization of the pterygoid nerve to prevent the occurrence of complications.

关 键 词：高分辨率CT 翼管神经 腭骨蝶突 腭鞘管 腭大管 圆孔 

分 类 号：R765[医药卫生—耳鼻咽喉科]