【摘要】 目的通过对鼻腔-上颌窦-翼腭窝-Meckel腔入路的内镜解剖学研究,为治疗Meckel腔肿瘤提供新的入路选择。方法对15具动静脉灌注乳胶的成人尸头标本进行模拟鼻内镜下该入路分层显微解剖,对相关解剖标志进行了观察、分析、拍摄和测量。结果该入路分为三步:进入上颌窦,进入翼腭窝,最后进入Meckel腔。追踪翼管神经血管束,解剖分离四方形空间可安全到达Meckel腔。鼻小柱至上颌窦口、蝶腭孔、翼管前孔距离分别为(44.08±2.61)mm、(64.83±2.42)mm和(70.43±2.94)mm。鼻小柱至上颌窦口连线,及其至蝶腭孔连线与腭骨水平板的夹角分别为(38.10±2.46)°和(6.15±2.26)°。结论鼻内镜下鼻腔-上颌窦-翼腭窝-Meckel腔入路是到达Meckel腔前下内面的安全且直接的入路,可用来治疗Meckel腔肿瘤。更多还原

【Abstract】 Objective To provide a new approach for the treatment of tumor in Meckel’s cave, by dissecting adjacent structures of the nasal cavity-maxillary sinus-pterygopalatine fossa-Meckel’s cave approach. Methods Fifteen adult cadaver heads (30 sides) were dissected and the correlated anatomic landmarks were observed, measured and analyzed in an operative route. Results The approach was divided into 3 steps: entering the maxillary sinus, the later pterygopalatine fossa and the final Meckel’s cave. Safe access to Meckel’s cave could be achieved by tracing the vidian neurovascular bundles and dissecting the quadrangular space (QS). The distances from the nasal columella to the apertura maxillaries, the sphenopalatine foramen, and the anterior foramen of the pterygoid canal were (44.08±2.61) mm, (64.83±2.42) mm, and (70.43±2.94) mm, respectively. The angles between the horizontal plate of the palatine bone and the link from nasal columella to apertura maxillaries, between the horizontal plate of the palatine bone and the link from nasal columella to sphenopalatine foramen were (38.10±2.46)° and (26.15±2.26)°, respectively. Conclusion The endoscopic approach of transnasal maxillary sinus-pterygopalatine fossa-Meckel’s cave (ENMPA) is a safe and direct way to access Meckel’s cave, and could be employed for the treatment of tumor in Meckel’s cave.更多还原