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目的通过对鼻腔-上颌窦-翼腭窝-Meckel腔入路的内镜解剖学研究,为治疗Meckel腔肿瘤提供新的入路选择。方法对15具动静脉灌注乳胶的成人尸头标本进行模拟鼻内镜下该入路分层显微解剖,对相关解剖标志进行了观察、分析、拍摄和测量。结果该入路分为三步:进入上颌窦,进入翼腭窝,最后进入Meckel腔。追踪翼管神经血管束,解剖分离四方形空间可安全到达Meckel腔。鼻小柱至上颌窦口、蝶腭孔、翼管前孔距离分别为(44.08±2.61)mm、(64.83±2.42)mm和(70.43±2.94)mm。鼻小柱至上颌窦口连线,及其至蝶腭孔连线与腭骨水平板的夹角分别为(38.10±2.46)°和(6.15±2.26)°。结论鼻内镜下鼻腔-上颌窦-翼腭窝-Meckel腔入路是到达Meckel腔前下内面的安全且直接的入路,可用来治疗Meckel腔肿瘤。
Objective To study the endoscopic anatomy of nasal cavity - maxillary sinus - pterygopalatine fossa - Meckel cavity and provide a new approach for the treatment of Meckel cavity tumors. Methods Fifteen adult cadaver specimens with arteriovenous perfusion latex were subjected to simulated endoscopic microdissection of the approach. The relevant anatomical landmarks were observed, analyzed, photographed and measured. Results The approach was divided into three steps: into the maxillary sinus, into the pterygopalatine fossa, and finally into the Meckel lumen. Tracing the pterygoid neurovascular bundle, dissecting the square space safely to the Meckel chamber. The distances from the columella to the maxillary sinus, butterflies palatal foramen, and anterior wing of the wing were (44.08 ± 2.61) mm, (64.83 ± 2.42) mm and (70.43 ± 2.94) mm, respectively. The angle between the columella and the maxillary sinus ostium was (38.10 ± 2.46) ° and (6.15 ± 2.26) °, respectively. Conclusions Endoscopic nasal-maxillary sinus-pterygopalatine-Meckel approach is a safe and direct approach to the anterior and medial face of Meckel cavity, which can be used to treat Meckel cavity tumors.