鼻内镜下翼腭窝手术入路研究

目的探讨鼻内镜下翼腭窝手术的可行性与解剖路径。方法10%甲醛充分固定的5例(10侧)成人头颅湿标本,在电视监视下,从鼻腔置入0°鼻内镜,依次切除中鼻甲、钩突、筛泡以及前后组筛房,扩大上颌窦口后咬除上颌窦口后部腭骨垂直部直达其与蝶骨交界处,全部切除上颌窦后壁内侧半骨壁,显露翼腭窝。分别用0°、30°鼻内镜充分暴露翼腭窝内的结构,逐层进行解剖,记录所涉及到的组织结构,探查其毗邻关系。结果所有标本均能满意显露翼腭窝。翼腭窝显露范围向上达眶尖,向下达翼腭窝底壁,向外能完全暴露翼突外板上半部分以及翼突根部,部分显露颞下窝。结论鼻内镜下可以满意显露翼腭窝,安全控制翼腭窝内所有血管神经等重要组织。

Operation path to pterygopalatine fossa under endoscope

[Objective] To explore the feasibility of operation on pterygopalatine fossa under endoscope.[Methods] Five 10% formaldehyde fixed wet adult skull specimen were studied.Under nasoendoscope,the middle turbinate,uncinate process,ethmoid bulla,anterior and posterior ethmoid sinuses were resected by turns.Then after punch out perpendicular part of palatine bone and posterior wall of maxillary,and the pterygopalatine fossa were showed and some related structures were explored.[Results] This pathway led to good view of pterygopalatine fossa.The exposed anatomic range showed superiorly orbit apex,inferiorly floor,laterally upper part of external lamina of pterygoid process and infratemporal fossa.[Conclusion] The endoscopic pterygopalatine fossa sugery is safe and practical from the anatomic structres.