筛骨解剖变异的CT评价及其临床意义

目的 评价冠状位CT对功能性内镜鼻窦外科有关的筛骨解剖变异的显示能力，讨论筛骨解剖变异的CT评价对临床手术的指导意义。资料与方法 冠状位CT薄层扫描整个筛骨45例，以筛骨的断层为依据，以内镜鼻窦手术为对照，认证筛骨的解剖变异，并计算各种变异的出现率。结果 筛顶的解剖学特征中，倾斜式占73．3％，高台式占26．7％；蝶上筛房占13．3％；眶下筛房占8．9％；中鼻甲的气化和反向偏曲各占17．8％和2．2％；鼻中隔的气化占6．7％，偏曲占22．2％，形态呈S型、弧型、侧置V型等。结论 冠状位CT能很好显示有关内镜鼻窦手术的筛骨解剖变异，为手术提供详细的影像学资料，对该手术有很大的指导意义。

CT Evaluation of Ethmoid Variations and Its Clinical Significance

Objective To evaluate coronal CT scanning in displaying the ethmoidal variations needed to know for functional endoscopic sinus surgery, and to discuss its clinical significance.Materials and Methods Coronal thin slice CT scanning of ethmoid bone was performed in 45 cases. The ethmoidal variations were judged by normal tomographic anatomy, and the occurrence rate of each variation was estimated.Results The following ethmoidal variations necessary for endoscopic sinus surgery were observed. (1) With regard to the features of ethmoidal roof, slope type was seen in 73.3% and platform type in 26.7%. (2) Onodi air cell was found in 8.9%. (3) Haller air cell was seen in 8.9%. (4) Pneumatized and deviated middle turbinate was seen in 17.0% and 2.2%, respectively. (5) Pneumatized and deviated nasal septum was seen in 6.7% and 22.2%, respectively.Conclusion Coronary CT images can clearly show the ethmoidal anatomic variations which are needed to know before functional endoscopic sinus surgery and which are of great value in guiding the operation.