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目的 为内窥镜下中鼻道上颌窦开窗提供解剖学参数。方法 在 2 0个尸体头颅上观测上颌窦窦口、鼻囟门及其毗邻结构。结果 ①上颌窦内口紧邻眶下壁 ,距离 (3 72± 0 6 3)mm ;鼻内开口与眶底最低处平行或高于该平面 ,矢状位上与眶纸板同处一垂面或居于其内侧。②上颌窦鼻内开口距离鼻泪管 (5 5 0± 3 73)mm。③鼻囟门上下径 (11 72± 2 10 )mm、前后径 (16 75± 6 30 )mm、厚度 (3 0 0± 0 6 8)mm、前界距离鼻泪管 (3 44± 0 75 )mm、后缘距鼻后外侧动脉 (8 79± 1 0 0 )mm ;鼻小柱基部至鼻囟门后缘为 (5 4 32±3 15 )mm。④眶下壁与下鼻甲上缘之间 ,随着移向下鼻甲后端 ,距离逐渐增宽。结论 上颌窦窦口及鼻囟门与眼眶和鼻泪管关系密切 ,内窥镜下中鼻道行上颌窦开窗 ,可沿下鼻甲上缘寻找窦口 ,咬除鼻囟门扩大窦口的安全方向为向下和向后 ,向前不能超过 5mm ,防止眼眶和泪道并发症的发生 ;同时谨防损伤鼻外侧后动脉
Objective To provide anatomical parameters for endoscopic middle meatus maxillary sinus fenestration. Methods Twenty maxillary sinus ostia, nasal fontanelle and their adjacent structures were observed on 20 corpses. Results ① The mouth of the maxillary sinus was close to the infraorbital wall at a distance of (372 ± 0 6 3) mm. The nasal opening was parallel to or above the lowest point of the orbital floor. The sagittal plane was perpendicular to the orbital cardboard or Living inside. ② Maxillary sinus nasal opening from the nasolacrimal duct (5 0 ± 3 73) mm. ③ The diameter of the fontanelle was 11 72 ± 2 10 mm, and the anteroposterior diameter was 16 75 ± 6 30 mm, the thickness was 300 ± 0 68, the distance from the nasolacrimal duct was 34 44 ± 0 75, mm, and the posterior border was 8 79 ± 1 0 mm from the posterior nasal posterolateral artery. The posterior border of the columella to the fontanel of the fontanel was (54 32 ± 3 15) mm. ④ between the infraorbital wall and inferior turbinate on the edge, with the shift to the inferior turbinate rear end, the distance gradually widened. Conclusion The maxillary sinus ostium and the fontanelle are closely related to the orbit and the nasolacrimal duct. The endoscopic middle-nasal tract is the most appropriate way to open the window of the maxillary sinus. The upper ostia of the inferior turbinate can be used to look for the ostium. The safe direction of the nasal fontanel Downward and backward, forward can not exceed 5mm, to prevent the occurrence of orbital and lacrimal ductal complications; while guarding against damage to the posterior nasal artery