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目的:探讨鼻腔泪囊的解剖结构及其与毗邻的关系,为鼻内镜下鼻腔泪囊造口术提供解剖学指导。方法:对15具(30侧)成人尸头的泪囊投影在鼻腔外侧壁上的解剖特点进行研究,同时观察了内眦韧带与泪囊的解剖关系。结果:泪囊在鼻腔外侧壁上的解剖位置投影大部(2/3)位于中鼻甲附着处(中鼻甲腋)前端上方,小部位于其下方;泪囊小部分(1/3)位于泪总管开口上方水平,大部位于该口下方;内眦韧带几乎横压于泪囊中部。中鼻甲腋可越过泪囊后界(11侧)或中线(1侧)。使用以内眦韧带为基准点的泪囊鼻外定位法,30侧标本全部定位于泪囊投影区较中心的位置。结论:建议术前行泪囊碘油造影CT检查,手术造口中心位置约为中鼻甲附着处以上1.5～2.0mm处稍前方。泪总管开口与泪囊的解剖关系恒定,术中使用激光光纤行泪道探查,并以透过鼻腔外侧壁上的光斑为定位标志相对精确,以内眦韧带为基准点的泪囊鼻外定位法准确度亦高。
Objective: To investigate the anatomic structure of nasal lacrimal sac and its relationship with adjacent to provide anatomic guidance for nasal lacrimal sac stoma under nasal endoscopy. Methods: Anatomical characteristics of dacryocystorhinostomies of 15 adult cadaver heads on the lateral wall of the nasal cavity were studied. At the same time, the anatomic relationship between the medial canthal ligament and the lacrimal sac was observed. Results: Most of the projection of the dacryocyst on the lateral wall of the nasal cavity was located above the anterior end of the middle turbinate (middle turbinate), the small part was below it. The small part of the dacryocyst (1/3) Explorer above the level of the opening, most of the mouth below; sacral ligament almost transverse pressure in the middle of the lacrimal sac. The middle turbinate axilla can pass beyond the dacryocystorhoid (11 side) or midline (1 side). Dacryocystorhinostomy using the ligament as the reference point, all 30 specimens located in the projection area of lacrimal sac more central position. Conclusion: It is recommended to perform preoperative dacryocystoscopic lipiodol CT examination. The center of the ostomy center is about 1.5 ~ 2.0mm above the middle turbinate attachment site. Lacrimal duct opening and the anatomy of the lacrimal sac constant intraoperative use of laser fiber lacrimal duct exploration, and through the outer wall of the nasal cavity for the relative positioning of the spot mark is relatively accurate, with the tarsal ligament as the reference point of the dacryocyst nasal localization Accuracy is high.