中鼻甲连续冠状断面解剖及3D数字重建

目的 探讨中鼻甲连续冠状位断面解剖特点,结合薄层CT扫描及3D数字重建,为自后向前的鼻窦手术提供结构解剖学基础。方法 4具（8侧）成人尸头标本,行鼻窦螺旋CT扫描获取图像后,行连续冠状位断面解剖,并对相应层面的CT图像进行结构标注,观察中鼻甲3部分的形态学特点及与CT影像的对应关系;通过薄层鼻窦CT进行3D立体数字重建中鼻甲。结果 连续冠状位断面解剖自后向前观察中鼻甲各部分形态特点为,中鼻甲水平部内侧游离端为球状并以板状结构附着于鼻腔外侧壁;板状结构向前分为前后骨板,前为筛泡基板,后为中鼻甲基板,斜行向前向上附着于脑板;在筛泡基板与中鼻甲基板之间为前组筛窦;中鼻甲垂直部自中鼻甲水平部以矢状位向上呈扇形附着于额鼻嵴及脑板;以冠状位断面解剖中鼻甲3部分典型形态标注鼻窦CT图像;完成了中鼻甲形态数字三维重建。结论 从冠状位断面形态观察,可以归纳出自后至前中鼻甲形态变化规律,为自后向前的手术径路提供解剖学依据。     

鼻腔结构矫正手术对OSAHS患者上气道流场影响的数值分析

目的研究伴鼻腔结构异常的OSAHS患者经鼻腔结构矫正手术后,气道结构形态的改变对患者整个上气道流场分布以及软腭运动姿态的影响。方法基于患者手术前后CT影像学数据,建立上气道及软腭三维有限元模型,采用流固耦合的方法模拟手术前后上气道流场特性及软腭的运动情况。结果手术矫正了异常的鼻腔结构形态,鼻腔及整个上气道阻力明显下降。术后软腭的肥厚水肿明显缓解,其游离缘的运动幅度减小。软腭运动幅度随弹性模量的减小而增大。术后的模拟结果与文献报道的正常人实验与模拟结果接近。结论鼻腔结构矫正手术改变了上气道结构,影响了气流流场的分布和软腭的运动姿态;不同病理生理状态下,软腭弹性模量的变化对其运动姿态有影响。     

Olfactory epithelium and ontogeny of the nasal chambers in the bowhead whale (Balaena mysticetus)

In a species of baleen whale, we identify olfactory epithelium that suggests a functional sense of smell and document the ontogeny of the surrounding olfactory anatomy. Whales must surface to breathe, thereby providing an opportunity to detect airborne odorants. Although many toothed whales (odontocetes) lack olfactory anatomy, baleen whales (mysticetes) have retained theirs. Here, we investigate fetal and postnatal specimens of bowhead whales (Balaena mysticetus). Computed tomography (CT) reveals the presence of nasal passages and nasal chambers with simple ethmoturbinates through ontogeny. Additionally, we describe the dorsal nasal meatuses and olfactory bulb chambers. The cribriform plate has foramina that communicate with the nasal chambers. We show this anatomy within the context of the whole prenatal and postnatal skull. We document the tunnel for the ethmoidal nerve (ethmoid foramen) and the rostrolateral recess of the nasal chamber, which appears postnatally. Bilateral symmetry was apparent in the postnatal nasal chambers. No such symmetry was found prenatally, possibly due to tissue deformation. No nasal air sacs were found in fetal development. Olfactory epithelium, identified histologically, covers at least part of the ethmoturbinates. We identify olfactory epithelium using six explicit criteria of mammalian olfactory epithelium. Immunohistochemistry revealed the presence of olfactory marker protein (OMP), which is only found in mature olfactory sensory neurons. Although it seems that these neurons are scarce in bowhead whales compared to typical terrestrial mammals, our results suggest that bowhead whales have a functional sense of smell, which they may use to find prey.     

Survey anatomy and histological observation of the nasal cavity of Tupaia belangeri chinensis (Tupaiidae,Scandentia, Mammalia)

This study aimed to provide researchers with an atlas of the survey anatomy, histology, and imaging of the nasal cavity of Tupaia belangeri chinensis. Seven T. b. chinensis adult males were euthanized and scanned using micro-computed tomography (CT). The nose was separated, and tissue sections were made on the coronal and axial planes to observe the survey anatomy and histological and imaging characteristics of the nose. T. b. chinensis contains one maxilloturbinal and three ethmoturbinals, one nasoturbinal, one interturbinal, two frontoturbinals, and one lamina semicircularis in the unilateral nasal cavity. Other identified structures were the ostiomeatal complex, vomeronasal organ, superior nasal vault, maxillary sinus, and frontal recess. The drainage pathways of the sinuses and nasal airflow in T. b. chinensis were confirmed. The vault epithelium consisted of the squamous epithelium, respiratory epithelium, transitional epithelium, and olfactory epithelium. Micro-CT confirmed our findings of the coronal tissue sections. The nasal cavity anatomy of T. b. chinensis is similar to that of some strepsirrhine primates. However, the airflow and olfactory function are quite different from that of humans. Our gross and histological atlas of the nasal septum, turbinals, maxillary sinus, and frontal recess provides a reference for researchers to use T. b. chinensis for nasal cavity functional research.     

Venous networks in the upper airways of bats: A histological and diceCT study

Our knowledge of nasal cavity anatomy has grown considerably with the advent of micro-computed tomography (CT). More recently, a technique called diffusible iodine-based contrast-enhanced CT (diceCT) has rendered it possible to study nasal soft tissues. Using diceCT and histology, we aim to (a) explore the utility of these techniques for inferring the presence of venous sinuses that typify respiratory mucosa and (b) inquire whether distribution of vascular mucosa may relate to specialization for derived functions of the nasal cavity (i.e., nasal-emission of echolocation sounds) in bats. Matching histology and diceCT data indicate that diceCT can detect venous sinuses as either darkened, “empty” spaces, or radio-opaque islands when blood cells are present. Thus, we show that diceCT provides reliable information on vascular distribution in the mucosa of the nasal airways. Among the bats studied, a nonecholocating pteropodid (Cynopterus sphinx) and an oral-emitter of echolocation sounds (Eptesicus fuscus) possess venous sinus networks that drain into the sphenopalatine vein rostral to the nasopharynx. In contrast, nasopharyngeal passageways of nasal-emitting hipposiderids are notably packed with venous sinuses. The mucosae of the nasopharyngeal passageways are far less vascular in nasal-emitting phyllostomids, in which vascular mucosae are more widely distributed in the nasal cavity, and in some nectar-feeding species, a particularly large venous sinus is adjacent to the vomeronasal organ. Therefore, we do not find a common pattern of venous sinus distribution associated with nasal emission of sounds in phyllostomids and hipposiderids. Instead, vascular mucosa is more likely critical for air-conditioning and sometimes vomeronasal function in all bats.     

Cranial Pair I: The Olfactory Nerve

The olfactory nerve constitutes the first cranial pair. Compared with other cranial nerves, it depicts some atypical features. First, the olfactory nerve does not form a unique bundle. The olfactory axons join other axons and form several small bundles or fascicles: the fila olfactoria. These fascicles leave the nasal cavity, pass through the lamina cribrosa of the ethmoid bone and enter the brain. The whole of these fascicles is what is known as the olfactory nerve. Second, the olfactory sensory neurons, whose axons integrate the olfactory nerve, connect the nasal cavity and the brain without any relay. Third, the olfactory nerve is composed by unmyelinated axons. Fourth, the olfactory nerve contains neither Schwann cells nor oligodendrocytes wrapping its axons. But it contains olfactory ensheathing glia, which is a type of glia unique to this nerve. Fifth, the olfactory axons participate in the circuitry of certain spherical structures of neuropil that are unique in the brain: the olfactory glomeruli. Sixth, the axons of the olfactory nerve are continuously replaced and their connections in the central nervous system are remodeled continuously. Therefore, the olfactory nerve is subject to lifelong plasticity. Finally seventh, the olfactory nerve can be a gateway for the direct entrance of viruses, neurotoxins and other xenobiotics to the brain. In the same way, it can be used as a portal of entry to the brain for therapeutic substances, bypassing the blood-brain barrier. In this article, we analyze some features of the anatomy and physiology of the first cranial pair. Anat Rec, 302:405–427, 2019. © 2018 Wiley Periodicals, Inc.     

基于Amira的OSAS动物模型阻塞形态可视化研究

上气道组织结构异常诱发的气道狭窄,是OSAS病人发生阻塞件呼吸暂停的病理学基础.通过动物实验.建立猪的OSAS模型.结合数字图像处理技术以及三维重建方法.从形态学上观测OSAS动物模型上气道阻塞部位及其形态.结果发现,模型猪在出现常见的OSAS表现30天之后.在其上气道鼻腔部位观测到明显的阻塞形态.表明建立的OSAS动物模型不仪可行,而且有效,能为OSAS力学仿真模型的建立以及OSAS疾病的临床诊治提供可靠基础.     

基于CT断层影像的颅骨解剖结构三维重建

目的:基于CT颅脑断面连续影像,利用Mimics 8.01软件对颅骨进行三维重建,为解剖学教学和研究提供模型.方法:利用Mimics软件对CT颅脑影像中的骨组织进行自动阈值分割后,对重建出的颅骨进行自动分割,分割出舌骨结构.对于其他颅骨结构,在Mimics软件中的三个方位CT图像中,利用定位线结合解剖学中的颅骨毗邻关系,找出区分毗邻颅骨之间的定位点.然后,根据事先规划的不同结构的分割颜色,人工描出相应的颅骨所在区域.随后,对分割出的各个颜色区域进行三维重建,重建出主要的脑颅骨和面颅骨结构,并分别在计算机上对上述结构进行观察.结果:成功对颅骨的结构分别以不同颜色进行分割,并分别重建出额骨、颞骨、枕骨、顶骨、蝶骨、筛骨、鼻骨、泪骨、上颌骨、下颌骨、腭骨、舌骨结构,在计算机中进行任意角度和单独观察.结论:基于CT颅脑断面影像可以对颅骨进行三维重建,为数字化颅骨解剖教学及颅脑手术导航奠定基础.     

Craniovascular variation in four late Holocene human samples from southern South America

Craniovascular traits in the endocranium (traces of middle meningeal vessels and dural venous sinuses, emissary foramina) provide evidence of vascular anatomy in osteological samples. We investigate the craniovascular variation in four South American samples and the effect of artificial cranial modifications (ACM). CT scans of human adult crania from four archeological samples from southern South America (including skulls with ACM) are used for the analyses. The craniovascular features in the four samples are described, skulls with and without ACM are compared, and additionally, South Americans are compared to a previously analyzed sample of Europeans. Of the four South American samples, the Southern Patagonian differs the most, showing the most distinct cranial dimensions, no ACM, and larger diameters of the emissary foramina. Unlike previous studies, we did not find any major differences in craniovascular features between modified and non-modified skulls, except that the skulls with ACM present somewhat smaller foramina. South Americans significantly differed from Europeans, especially in the anteroposterior dominance of the middle meningeal artery, in the pattern of sinus confluence, in the occurrence of enlarged occipito-marginal sinuses, and in foramina frequencies and diameters. Craniovascular morphology is not affected by the cranial size, even in skulls with ACM, indicating a minor or null influence of structural topological factors. Concerning the samples from distinct geographic and climatic environments, it must be evaluated whether the craniovascular morphogenesis might be partially influenced by specific functions possibly associated with thermoregulation, intracranial pressure, and the maintenance of intracranial homeostasis.     

Olfactory Neuroblastoma: A Case Report

A neuroblastoma arising in the nasal cavity of a 66-year-old male invaded the frontal sinus and extended into the cranial cavity. Light microscopy revealed sheets of small ovoid cells and many small glands bordered by columnar cells which were strongly immunoreactive to epithelial markers. Focal reactivity for synaptophysin and chromogranin was seen within the sheets of small cells. Electron microscopy confirmed the presence of olfactory differentiation.     

OSAHS患者自然睡眠期呼吸模式对上气道流场的影响

目的分析阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)患者自然睡眠时平静呼吸和呼吸暂停期不同压力边界条件和呼吸模式对气道内气体的流动和生理状态的影响。方法创建OSAHS患者仰卧位自然睡眠状态,并采集CT数据建立三维上气道有限元模型。临床测量患者睡眠期喉腔压力作为边界条件,考虑鼻吸鼻呼、鼻吸口呼、口吸鼻呼、口吸口呼4种典型呼吸模式进行流体力学仿真。结果睡眠期OSAHS患者的呼吸气流呈非稳定、有涡、双向流动,压力边界以及呼吸模式对气体流动的影响明显。用口呼吸与用鼻呼吸相比,气体的最大流速有所升高,压降主要集中在口腔,吸气时升高约30%,呼气时升高1倍。结论采用OSAHS患者自然睡眠期CT数据建模并以临床喉腔压力作为边界条件进行有限元仿真具有意义,研究结果有助于了解OSAHS患者真实自然睡眠状态下的上气道流场特性。     

Effects of single-sided inferior turbinectomy on nasal function and airflow characteristics

Knowledge of airflow characteristics in the nasal cavity is essential to understanding the physiologic and pathologic aspects of nasal breathing. Airflows inside post-surgery models were investigated both experimentally and numerically to simulate the inferior turbinectomy. The left cavities of all three models are normal and right cavity is modified by (1) excision of the head of the inferior turbinate, (2) resection of the lower fifth of the inferior turbinate, and (3) resection of almost the entire inferior turbinate. Thin-slice CT (computed tomography) data (0.6mm deep) and meticulous refinement of the model surface by over a decade-long collaboration between engineers and an experienced ENT doctor resulted in the creation of sophisticated nasal cavity models. After numerical experiments and validation by comparison with the PIV results, the CFD code using the Reynolds stress turbulent model and variable temperature boundary condition on the mucosal wall was chosen as the proper numerical framework. Both global quantities (pressure drop, flow rate ratio, total wall heat transfer) and local changes (velocity, temperature, humidity, pressure gradient, and wall shear stress) were numerically investigated. The turbinectomy obviously altered the main stream direction. The flow rate in the upper airway near the olfactory slit decreased in models (1) and (3). This may weaken the olfactory function of the nose. Fluid and thermal properties that are believed to be related with physiology and prognosis are dependent on turbinate resection volume, position, and manner. Widening of the inferior airway does not always result in decreased flow resistance or wall heat transfer. The gains and losses of inferior turbinectomy were considered by analysis of the post-surgery model results. Nasal resistance was increased in model (1) due to sudden airway expansion. Nasal resistance increased and the wall heat transfer decreased in model (3) due to sudden airway expansion and excessive reduction of the mucosal wall surface area. Local shear stress and pressure gradient levels were increased in models (1) and (3).     

Olfactory Neuroblastoma: A Case Report

A neuroblastoma arising in the nasal cavity of a 66-year-old male invaded the frontal sinus and extended into the cranial cavity. Light microscopy revealed sheets of small ovoid cells and many small glands bordered by columnar cells which were strongly immunoreactive to epithelial markers. Focal reactivity for synaptophysin and chromogranin was seen within the sheets of small cells. Electron microscopy confirmed the presence of olfactory differentiation.     

基于磁共振图像的鼻腔边界分割及解剖结构提取简

目的探索基于系列磁共振图像获取鼻腔边界的有效分割方法．对图像进行准确分割并考察鼻腔的解剖结构。方法受试者为健康男性,年龄24岁。采用层间距为4mm的冠状面头颈部MRI图像．用MATLAB编程对图像预处理。使用距离正则化水平集图像分割方法分割鼻腔的边界．并借助插值算法计算任意位置的鼻腔横截面积．以及通过对横截面积分布曲线的积分算出鼻腔体积。结果精确分割出鼻腔边界,获得其坐标,并可保存为图像格式或数据文件格式。给出左、右鼻腔横截面积随距离变化的连续分布曲线、鼻腔最小截面的位置．以及鼻腔体积。结论该方法可以有效地分割出几何形态复杂的鼻腔的边界并获得鼻腔的结构参数数值．所得到的边界坐标数据可方便地用于鼻腔结构的三维重建。     

慢性鼻-鼻窦炎患者嗅觉功能与鼻内镜评分、鼻窦CT评分的相关性

目的:研究慢性鼻-鼻窦炎(chronic rhinosinusitis,CRS)患者嗅觉功能与Lund-Kennedy鼻内镜评分、Lund-Mackay鼻窦CT评分的相关性研究分析.方法:选择CRS住院患者200例.其中CRS(不伴鼻息肉)患者:95例;CRS(伴有鼻息肉)患者:105例,每组患者均进行病史采集,嗅觉功能检测、鼻内镜评分以及鼻窦CT评分.应用SPSS 13.0统计软件,对以上两个评分结果与嗅觉功能进行相关性分析.结果:CRS(不伴鼻息肉)或(伴有鼻息肉)患者中,Lund-Mackay鼻窦CT评分结果和Lund-Kennedy鼻内镜评分结果均是:随着嗅觉功能的下降,分数逐渐增加(P<0.01).结论:CRS患者与Kennedy鼻内镜评分和Lund-Mackay鼻窦CT评分均具有相关性;与CRS(不伴鼻息肉)患者的嗅觉功能最密切相关的是Lund-Mackay鼻窦CT评分;与CRS(伴有鼻息肉)患者的嗅觉功能最密切相关的是与Lund-Kennedy鼻内镜评分.     

Morphology of the olfactory fossa – A new look

IntroductionThe olfactory fossa is a depression in the anterior cranial cavity whose floor is the cribriform plate of the ethmoid bone. This delicate bony plate separates the anterior cranial fossa from the nasal cavity.MethodsWe studied the morphology of the olfactory fossa in 32 dry skulls, derived from North India, of undetermined sex, using a hydroxyphilicsiloxane based gel. Molds of the olfactory fossa and adjacent cranial fossa were made and measurements of length, width, depth and angle of embankment (angle between the lateral wall of the olfactory fossa and the medial part of the anterior cranial fossa) were done on them and their coronal sections.ResultsThe average length of the olfactory fossa was 2.11 cm. The average width was 0.39 cm and the mean angle of embankment was 130.5°. According to the measured depth, the incidence of Keros’ type I (1–3mm) was 23.44%, type II (4–7mm) – 70.83% and type III (8–16mm) – 5.73%. Type III was more frequent on the left side. The fossa in north India is deeper in the middle than its anterior and posterior ends. It had a narrow anterior and broad posterior end (54.69%). There were no overall significant differences between the right and left side for the various morphometric parameters.DiscussionThis study provides baseline morphometric data of the olfactory fossa in the North Indian population and this knowledge may help the radiologists to analyze scans of this region and minimize complications associated with surgeries in this delicate area.     

Some anatomical and histological studies on the arterial supply of the nasal cavity of the buffalo in Egypt (Bos bubalis L.).

The nasal cavity of the buffalo received its blood supply from the sphenopalatine and the external ethmoidal arteries; the former vessel chiefly supplied the respiratory portion of the nasal mucosa, while the latter was distributed to the olfactory region. The greater palatine artery supplied a palatonasal branch in the most extreme oral part of the nasal floor. The nasal vestibule received bronches from both the maxillary labial and infraorbital arteries. The arteries are of the muscular type and presented in addition ot the usual structure of their walls, thin-walled and thick-walled types. Stalked polsters are encountered in the branches of the arterial vessels having walls of the normal thickness. The appearance of the longitudinally arranged smooth muscle fibers found in the intime of some of the subepithelial small arteries and arterioles is suggestive of their epitheloid structure.