【作者】 周怀恩； 慈军； 方英； 管骅； 沈国勤；

【Author】 Zhou Huai-en,Ci Jun,Fang Ying,Guan Hua,Shen Guo-qin(Department of Otolaryngology;Red-Cross Hospital of Hang zhou.310003,China)

【机构】 杭州市红十字会医院；

【摘要】 目的:为了了解后筛窦气化发育对前颅底外科及蝶鞍区手术的影响及术前指导意义。方法:取50具成人头颅标本,行冠状位、矢状位及水平位薄层CT扫描,从不同层面及不同方位观测后筛窦的气化发育情况。结果:发现属管前型的占23%(23侧);半管型的占28%(28侧);全管型的占33%(33侧);蝶鞍型的占16%(16侧)。其中两侧气化分型完全相同者占33例(66侧);两侧气化不相同者占17例(34侧)。发现属Ⅰ°后筛窦的占43%(43侧);属Ⅱ°后筛窦的占35%(35侧),其中属Ⅱa°后筛窦的占19%(19侧),属Ⅱb°后筛窦的占16%(16侧);属Ⅲ°后筛窦的占22%(22侧)。其中两侧分度完全相同者占29例(58侧);两侧分度不相同者占21例(42侧)。另外,测得最后筛房的矢状径位于5.82～21.48mm之间;垂直径位于9.36～26.02mm之间;左右径位于5.88～23.64mm之间。其中,最后筛房大于或等于同侧蝶窦腔的有23%(23侧)。结论:后筛窦影像解剖分型分度对前颅底外科及蝶鞍区手术具有实际的指导意义。更多还原

【Abstract】 Objective:Development of the posterior ethmoid sinus affects the surgical approach via saddle area.Methods:Coronal,sagittal and axial slice CT scan were performed on 50 adult head specimens to observe the pneumatization and development of the posterior ethmoid sinus on deferent slices and directions.Result:It was found that pre-canal type were 23%(23 sides),half-canal type 28%(28 sides),canal type 33%(33 sides),and sella-tucicca type 16%(16 sides).In our cases,33 cases(66 sides) were identical pneumatization and classification of both sides,while 17 cases(34 sides) were non-identical.Moreover,43%(43 sides) were belong to Ⅰ°posterior ethmoid sinus,35%(35 sides) were belong to Ⅱ°posterior ethmoid sinus,of whichⅡa° 19 sides andⅡb° 16 sides,and 22%(22 sides) were belong toⅢ°.Identical classification of both sides were found in 29 cases(58 sides),non-idenfical were found in 21 cases(42 sides).Sagittal diameter of the most posterior ethmoidal cells 5.82-21.48mm,vertical diameter 9.36-26.02mm,transversal diameter 5.88-23.64mm.There are 23%(23 sides) in which the most posterior ethmoidal cells are larger than or equal to the sphenoid sinus of the same side.Conclusions:The imaging anatomic classification of posterior ethmoid sinus is the instructive significance for basicranil surgery and the surgical approach via saddle area.更多还原