与鼻内镜手术相关的鼻泪管应用解剖学研究

目的对鼻泪管及其周围结构进行测量,为临床鼻内镜手术提供解剖学依据。方法对20具40侧国人成人无异常病损尸头的膜性鼻泪管进行解剖学测量。结果女性鼻泪管长度、上口径、中段径、下口径、口棘距、口甲距、窦口距和鼻泪管仰角分别为(14.16±2.32)、(2.67±0.48)、(3.81±0.53)、(4.27±0.85)、(21.03±2.78)、(10.60±1.67)、(4.02±1.05)mm和64.31°±6.29°;男性的相应各项指标分别为(16.73±2.22)、(3.09±0.61)、(4.36±0.80)、(4.27±1.79)、(22.34±0.61)、(10.52±2.26)、(3.73±0.79)mm和66.20°±7.46°。其中,男性鼻泪管长度、上口径、中段径与女性比较,差异有显著性(t=2.479~3.866,P<0.05),其余各项指标比较差异无显著性(P>0.05)。结论男女性膜性鼻泪管差异较大,与周围结构关系密切,是鼻内镜手术易损伤部位。

A STUDY ON NASAL-ENDOSCOPIC-SURGERY-RELATED APPLIED ANATOMY OF NASOLACRIMAL DUCT

Objective To measure nasolacrimal duct and its surrounding structures and provide anatomical basis for nasal endoscopic surgery. Methods Membranous nasolacrimal ducts in 20 adult cadaver heads without abnormal lesions were measured anatomically. Results The data measured in female for the length of nasolacrimal duct,upper caliber,midpiece caliber,inferior caliber,oral papilla distance,buccal armature distance,apertures distance and elevation angle of nasolacrimal duct were(14.16±2.32),(2.67±0.48),(3.81±0.53),(4.27±0.85),(21.03±2.78),(10.60±1.67),(4.02±1.05) mm and 64.31°±6.29°,respectively;and that in male were(16.73±2.22),(3.09±0.61),(4.36±0.80),(4.27±1.79),(22.34±0.61),(10.52±2.26),(3.73±0.79) mm and 66.20°±7.46°,of which,the length of the duct was longer,and its upper and midpiece calibers were larger than that in female,the difference being significant(t=2.479-3.866,P<0.05). Conclusion The difference of membraneous nasolacrimal duct between male and female is comparatively big,the organ is closely related with the surrounding structures and easily to be injured at nasal endoscopic surgery.