避免鼻内窥镜手术并发症的临床解剖

目的：为避免鼻内窥镜手术并发症提供解剖学基础。方法：在３０侧成人头部正中矢状剖面标本上，观察了泪囊的毗邻、在鼻腔外侧壁上的投影及筛窦的毗邻。结果：泪囊与中鼻道前房相邻，其在鼻腔外侧壁上投影的前界为“骨梭”，后界为钩突基部，上界为中鼻甲附着处前部的下缘，下界为下鼻甲附着处前部的上缘。筛顶壁为一前窄后宽的骨板，筛前、后动脉在筛窦内均靠筛顶下方并与筛板同水平走行。结论：鼻内窥镜手术者若熟悉手术区的解剖可减少或避免并发症。

The Clinical Anatomy of Avoiding Complications from Endoscopic Nasal Surgery

Objective: To provide an anatomical basis for avoiding complications from endoscopic nasal surgery. Methods: The syntopy of dacryocyst, the projection on nasal cavity wall of the dacryocyst and the syntopy of ethmoidal sinuses were observed on the median sagittal plane of adult head. Results: The dacryocyst was found to adjoin the anterior antrum of the middle meatus.Its anterior landmark reflected on the nasal lateral wall is bone fusiformwhile the posterior landmark is the basal portion of processus ancinatus upper landmark is the inferior border of the middle nasal conchae point of attachment anterior,and the lower landmerk is the superior border of the inferior nasal conchae point of attachment anterior.The ethmoidal roof is a bone plate which is anterior narrow but posterior.The anterior and posterior ethmoidal arteries penetrate below the ethmoidal roof at the same level of cribriorform in ethmoid sinuses. Conclusion: The awareness of the anat omy of the field of operation may reduce the occurence of complications.