本文關(guān)鍵詞：翼腭窩上頜竇進(jìn)路的解剖學(xué)研究　出處：《昆明醫(yī)學(xué)院》2006年碩士論文　論文類型：學(xué)位論文

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【摘要】：[目的]：通過(guò)對(duì)翼腭窩骨性標(biāo)志和血管神經(jīng)的測(cè)量為翼腭窩的手術(shù)提供形態(tài)學(xué)標(biāo)志。 [方法]：在20個(gè)(40側(cè))干顱骨上對(duì)翼腭窩的重要結(jié)構(gòu)(翼腭裂，蝶腭孔，翼管等)的形狀，大小及毗鄰結(jié)構(gòu)進(jìn)行測(cè)量。在10個(gè)(20側(cè))10％的福爾馬林固定的成人尸體頭顱標(biāo)本進(jìn)行模擬上頜竇入路進(jìn)行解剖，測(cè)量相關(guān)的參數(shù)，然后對(duì)這些濕顱骨進(jìn)行正中矢狀切開(kāi)，在手術(shù)顯微鏡下自正中向外側(cè)打開(kāi)上頜竇的內(nèi)壁，翼腭窩的內(nèi)壁，觀察翼腭窩內(nèi)三叉神經(jīng)上頜支，上頜動(dòng)脈的走行，進(jìn)行上頜支的屬支的測(cè)量。 [結(jié)果]：翼腭窩呈一狹長(zhǎng)的漏斗型間隙，經(jīng)八個(gè)自然管道與鼻腔，口腔，咽，眶，顳下窩，顱中窩相交通其主要內(nèi)容物包括上頜動(dòng)脈翼腭段及其分支，上頜神經(jīng)及蝶腭神經(jīng)節(jié)等。翼腭窩內(nèi)組織分為的神經(jīng)層，，血管層。 [結(jié)論]： 1 翼腭窩的解剖結(jié)構(gòu)復(fù)雜，血管神經(jīng)豐富，毗鄰結(jié)構(gòu)重要，熟知此區(qū)的顯微解剖對(duì)手術(shù)治療翼腭窩區(qū)的病變具有重要意義。 2 對(duì)于翼腭窩的病變可以采取上頜竇進(jìn)路在打開(kāi)上頜竇的后壁時(shí)可以以上頜竇的內(nèi)壁頂壁和后壁三者的交點(diǎn)為解剖標(biāo)志。用磨鉆打開(kāi)骨壁暴露翼腭窩。 3 手術(shù)時(shí)可以以圓孔和翼管為安全標(biāo)志，建立起手術(shù)的安全界限。有助于保護(hù)重要結(jié)構(gòu)，防止手術(shù)誤入顱內(nèi)。翼腭窩內(nèi)的上頜動(dòng)脈具有較多的變異，并且因人種不同有差異需要加以保護(hù)。 4 上頜竇進(jìn)路具有暴露直觀，副損傷小且避免顳側(cè)進(jìn)路損傷面神經(jīng)的優(yōu)點(diǎn)。
[Abstract]:[Objective: to provide morphological markers for the operation of pterygopalatine fossa by measuring the bone and blood vessels of pterygopalatine fossa. [Methods: the shape of the pterygopalatine fossa (pterygopalatine fissure, sphenopalatine foramen, pterygopalatine canal, etc. The size and adjacent structure were measured. 10% formalin fixed adult cadaveric head specimens were dissected by simulated maxillary sinus approach and related parameters were measured. Then the middle sagittal incision of these wet skulls was performed, and the inner wall of maxillary sinus and pterygopalatine fossa were opened from the middle to the lateral under the operating microscope, and the maxillary branches of the trigeminal nerve and the maxillary artery were observed in the pterygopalatine fossa. The branches of maxillary branches were measured. [Results: the pterygopalatine fossa presented a long narrow funnel space. Its main contents included the pterygopalatine segment of the maxillary artery and its branches through eight natural conduits, oral cavity, pharynx, orbit, infratemporal fossa and middle cranial fossa. Maxillary nerve and sphenopalatine ganglion, etc. The pterygopalatine fossa is divided into nerve layer and vascular layer. [Conclusion]: 1 the anatomical structure of pterygopalatine fossa is complex, the vascularity and nerve are abundant, and the adjacent structure is important. It is important to know the microanatomy of pterygopalatine fossa for surgical treatment. 2. For the lesion of pterygopalatine fossa, maxillary sinus approach can be used to open the posterior wall of maxillary sinus, which can be marked by the intersection of the top wall and posterior wall of the maxillary sinus, and to open the pterygopalatine fossa with grinding drill to expose the pterygopalatine fossa. 3The safe limit of operation can be established by using foramen and pterygoid canal as safety markers. It is helpful to protect the important structure and prevent the operation from entering the skull by mistake. The maxillary artery in pterygopalatine fossa has more variation. And different people have different species need to be protected. 4 maxillary sinus approach has the advantages of direct exposure, small collateral injury and avoiding injury of facial nerve via temporal approach.
【學(xué)位授予單位】：昆明醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2006
【分類號(hào)】：R322

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