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目的对上颌窦-翼腭窝-海绵窦手术入路相关结构进行显微外科解剖学研究,为手术入路提供解剖学基础。方法利用10例经福尔马林固定的国人成人尸头共20侧,完全模拟该手术入路,对入路相关解剖标志进行了详细地显微解剖、观察、拍摄、测量和统计。结果上颌窦后壁与翼腭窝区结构复杂,有重要的神经和血管经过,是颅前、中窝与鼻腔、窦肿瘤互相蔓延的通道。该入路可较好地显露海绵窦前外侧相关的结构。结论该手术入路是海绵窦入路的一个特殊方法,拓展海绵窦手术入路的路径,为利用颅底硬膜外间隙进行入路提供了依据。
Objective To study the microsurgical anatomy of the maxillary sinus - pterygopalatine fossa - cavernous sinus approach to provide an anatomical basis for surgical approach. Methods 10 adult autopsy cadaver heads fixed in formalin were used to simulate the surgical approach completely and the anatomical landmarks related to the approach were micro dissected, observed, photographed, measured and statistically analyzed. Results The structures of the posterior wall of the maxillary sinus and the pterygopalatine fossa were complex and had important nerves and blood vessels passing through. They were the channels between the anterior cranial fossa, middle fossa, nasal cavity and sinus tumor. The approach can better reveal the anterior cavernous sinus related structures. Conclusions The surgical approach is a special method for cavernous sinus approach, which can expand the path of cavernous sinus surgery and provide the basis for the approach of using the skull base epidural space.