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目的:为了了解后筛窦气化发育对前颅底外科及蝶鞍区手术的影响及术前指导意义。方法:取50具成人头颅标本,行冠状位、矢状位及水平位薄层CT扫描,从不同层面及不同方位观测后筛窦的气化发育情况。结果:发现属管前型的占23％(23侧);半管型的占28％(28侧);全管型的占33％(33侧);蝶鞍型的占16％(16侧)。其中两侧气化分型完全相同者占33例(66侧);两侧气化不相同者占17例(34例)。发现属Ⅰ°后筛窦的占43％(43侧);属Ⅱ°后筛窦的占35％(35侧),其中Ⅱa°后筛窦的占19％(19侧),属Ⅱb°后筛窦的占16％(16侧);属Ⅲ°后筛窦的占22％(22侧)。其中两侧分度完全相同者占29例(58侧);两侧分度不相同者占21例(42侧)。另外,测得最后筛房的矢状径位于5.82～21.48mm之间;垂直径位于9.36～26.02mm之间;左右径位于5.88～23.64mm之间。其中,最后筛房大于或等于同侧蝶窦腔的有23％(23侧)。结论:后筛窦影像解部分型分度对前颅底外科及蝶鞍区手术具有实际的指导意义。
OBJECTIVE: To understand the influence of posterior ethmoidal vaporization on the operation of anterior skull base surgery and sella region and its preoperative guiding significance. Methods Fifty adult skull specimens were taken from the coronal, sagittal and horizontal thin-section CT scans to observe the gasification development of the ethmoid sinus at different levels and orientations. Results: 23% (23 sides) of the anterior preponderance type, 28% (28 sides) of the semi-tubular type, 33% (33 sides) of the total ductal type and 16% (16 sides) of the sella type ). There were 33 cases (66 sides) with the same gasification type on both sides, and 17 cases (34 cases) with different gasification on both sides. Found after the I ° posterior ethmoid sinus accounted for 43% (43 side); Ⅱ ° posterior ethmoid sinus accounted for 35% (35 side), of which Ⅱ a ° posterior ethmoid sinus accounted for 19% (19 side), is Ⅱ b ° Ethmoid sinus accounted for 16% (16 sides); belongs to Ⅲ ° posterior ethmoid sinus accounted for 22% (22 sides). There were 29 cases (58 sides) with identical index on both sides and 21 cases (42 sides) on both sides. In addition, the measured sagittal diameter of the final screen was between 5.82 ~ 21.48mm; the vertical diameter was between 9.36 ~ 26.02mm; the left and right diameter was between 5.88 ~ 23.64mm. Among them, the last screen room is greater than or equal to 23% of ipsilateral sphenoid cavity (23 sides). Conclusion: Partial posterior ethmoidectomy has practical guiding significance in the surgical treatment of anterior skull base and sellar region.