鼻内镜下经鼻径路解剖翼腭窝区临床观察

目的 研究鼻内镜下经鼻径路观察翼腭窝区的临床解剖特点, 以期为手术提供参考。方法 5例(10侧)成人尸头标本经乳胶灌注后, 在0°鼻内镜下分别经蝶腭孔和上颌窦后壁两种手术径路显露翼腭窝, 再开放蝶窦, 充分暴露视神经、颈内动脉及蝶窦外侧壁相关结构, 观察各解剖结构的三维立体关系。结果 不同手术径路显露翼腭窝的范围不同, 祛除上颌窦内侧壁后能最大程度显露翼腭窝内所有解剖结构, 开放蝶窦后能观察翼腭窝与蝶窦区域相关结构的解剖关系。结论 只要熟悉鼻内镜下翼腭窝及邻近区域的解剖结构及关系, 选择合适的病例, 鼻内镜下经鼻行翼腭窝区手术是安全可行的。

Endoscopic endonasal approach to the pterygopalatine fossa:an anatomic study

Objective To investigate the related anatomy in the pterygopalatine fossa under endoscopy so as to provide anatomical data for endoscopic transnasal surgery. Methods Five (10 sides) cadaveric heads were dissected via sphenopalatine foramen approach and via the posterior wall of the maxillary sinus approach to show the pterygopalatine fossa, then the sphenoid sinus was dissected to show the optic nerve, internal carotid artery and other anatomical structures. Results Different approaches allowed for different exposure of the pterygopalatine fossa structures. All the important anatomical structures and their relations in and around the pterygopalatine fossa could be observed under endoscopy. Conclusion The endoscopic transnasal surgery in the pterygopalatine fossa is feasible and safe as if surgeons master the related anatomy and choose right cases.