【摘要】 目的回顾近年来有关蝶窦的解剖研究，总结其在鞍区手术中的意义。方法分析近年来有关的文献２３篇。结果蝶窦于１０岁时基本气化完全，其大小、形态、气化程度和分隔均变异极大。蝶窦内中隔很少居中，视神经和颈内动脉常不同程度地凸向窦腔。后筛窦亦可伸入蝶窦，形成蝶上筛房。自蝶窦口至鞍底中心的距离大约为１．５ｃｍ。结论经蝶入路手术中，保持与鼻底成３２°夹角入路和以两侧窦口下缘连线为横轴打开窦壁，可使手术准确导向鞍内，必要时可打开蝶上筛房。蝶骨前嵴和犁骨是指引窦内中线操作的可靠标志，入窦腔后应注意识别和保护侧壁上的隆起结构。若见窦腔浅，看不到鞍底下凸，即可能存在额状位间隔、蝶窦气化不良或鞍底本身不下凸。更多还原

【Abstract】 Objective To review the study of the anatomy of the sphenoid sinus (SS) in recent years and summarize its significance in the operation at the sellar region. Methods Twenty - three articles in recent years were analyzed. Results Pneumatization of SS was basically complete in all the patients when they were 10 years old. The size, form, degree of pneumatization and septum of all the patients varied widely. The intersinal septum in SS was seldom in the midline. Optic nerves and internal carotid arteries usually protruded into SS. Posterior ethmoidal sinuses extended into SS in some cases and formed supersphenoid - ethoid cells. The distance from the sinus osmium to the sellar floor was about 1. 5cm. Conclusion In order to enter the hypophyseal fossa accurately in the operation using the transsphenoidal approach, the angle between the direction of the operation and nasal floor should be 32° and SS be opened through a horizontal line connecting lower margins of two ostia. Supersphenoid - ethoid cells may be opened intentionally if necessary. The anterior crest of the sphenoid bone and vomer bone are both accurate guides to the midline of SS. The protrusion of the lateral walls of SS should be identified and protected carefully. If the cavity of SS was superficial and the protrusion of the sellar floor was not seen, it is possible that a coronal septum, poor pneumatization of SS or a disprotruded sellar floor exists.更多还原