鼻内镜下蝶腭动脉区的外科解剖

目的探讨鼻内镜下蝶腭动脉区的解剖学特点。方法采用鼻内镜对10例(20侧鼻腔)经10%福尔马林溶液固定的正常成人尸头标本的蝶腭动脉及其与相关结构的关系进行解剖,观察蝶腭孔定位,筛骨嵴的形态、大小及其与蝶腭孔的关系;测量筛骨嵴与前鼻棘的间距以及筛骨嵴与中鼻甲尾端的间距,观察蝶腭动脉分支及其走行。结果筛骨嵴略呈三角棘状骨性结构,表面粗糙,位于蝶腭孔的前上方。去除筛骨嵴后可见蝶腭动脉血管束从蝶腭孔中穿出,蝶腭动脉常有2~3支不等分支。筛骨嵴与前鼻棘间距为(50.1±2.6)mm,筛骨嵴与中鼻甲尾端的间距为(9.1±1.1)mm。结论蝶腭动脉在出蝶腭孔之前可能有分支;筛骨嵴位置固定,是经鼻内镜下定位蝶腭动脉及蝶腭孔的重要解剖标志。

Nasal endoscopic anatomy of sphenopalatine arteryQI Jian wei, WU Yuan qing, CAO Ping,et al

Objective To explore the anatomical characteristics of sphenopalatine artery under nasal endoscope. Methods Heads of 10 formalin-fixed cadavers （20 sides ） were dissected endoscopically to observe the sphenopalatine artery and its surrounding structures. The observed parameters included the localization of sphenopalatine foramen, the shape and size of ethmoidal crest, and the relationship between sphenopalatine foramen and ethmoidal crest. The distance from ethmoidal crest to anterior nasal spine and that from ethmoidal crest to the tail end of middle turbinate were measured. The branch types and courses of sphenopalatine artery were also explored. Results Ethmoidal crest was a bony structure with triangle shape and rough surface, and located anteriorly to the top of sphenopalatine foramen. After elimination of ethmoidal crest, the sphenopalatine artery was emerged from the sphenopalatine foramen with 2 to 3 branches. The distances from ethmoidal crest to anterior nasal spine and to tail end of the middle turbinate were （ 50. 1 ± 2.6 ） mm and （ 9. 1± 1. 1 ） mm respectively. Conclusions The ethmoidal crest is an essential and reliable landmark for endoscopic localization of sphenopalatine artery and foramen. Branches may exist before emergence of sphenopalatine artery from sphenopalatine foramen.