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目的:通过鼻内镜下鼻腔外侧壁入路对翼腭窝的解剖学研究,为临床内镜下翼腭窝手术入路提供解剖学基础。方法:10具新鲜尸头采用内镜下鼻腔外侧壁入路对翼腭窝进行解剖,观测手术径路中重要标志及穿经血管神经结构,并观测翼腭窝内结构及其与周围结构的关系。结果:①翼腭窝及其周围结构解剖关系复杂,颌内动脉及其分支变异较大;②蝶腭孔、眶下管、圆孔和翼管是翼腭窝重要骨性标志,同时翼腭窝可作为进入颞下窝和蝶窦的通路。结论:①熟知翼腭窝及其周围恒定的解剖标志可保持方向感,提高手术安全性;②鼻内镜下经鼻腔外侧壁入路可充分暴露翼腭窝,视野清晰,术中对重要神经血管控制较好,可根据病变范围变通手术径路;③经鼻内镜下鼻腔外侧壁入路可进入翼腭窝临近区域,处理临近区域病变。
OBJECTIVE: To anatomize the pterygopalatine fossa by endoscopic nasal lateral wall approach and to provide anatomical basis for surgical approach of pterygopalatine fossa under clinical endoscopy. Methods: Ten fresh cadaver heads were used to anatomize the pterygopalatine fossa by endoscopic nasal lateral wall approach. The important signs in the surgical approach and the vascular nerve structures were observed. The relationship between the internal structure of pterygopalatine fossa and the surrounding structures was observed . Results: ① The anatomical relationship between the pterygopalatine fossa and its surrounding structures is complex, and the variation of the internal mammary artery and its branches is large. ② The sphenopalatine fossa, the infraorbital foramen, the foramen and the fistula are the important bony markers of the pterygopalatine fossa. Nest can be used as access to the infratemporal fossa and sphenoid sinus. Conclusion: ① familiar with the pterygopalatine fossa and its surrounding constant anatomical landmarks to maintain the sense of direction and improve the safety of surgery; ② endoscopic nasal approach through the lateral ploys well exposed pterygopalatine fossa, clear vision, the operation of important nerves Vascular control is better, according to the lesion range alternative surgical pathways; by nasal endoscopic nasal lateral wall approach can enter the pterygopalatine fossa near the area, the treatment of the adjacent area lesions.