本文關鍵詞： 鼻內(nèi)鏡 鼻腔 鼻竇 解剖 手術　出處：《山西醫(yī)科大學》2010年碩士論文　論文類型：學位論文

【摘要】： 目的：通過尸頭解剖,明確鼻腔主要解剖結構的位置、形態(tài)、變異、毗鄰關系,探討各結構在鼻內(nèi)鏡下諸多手術術式中的解剖學意義,為個性化手術方案的制定提供依據(jù),同時制作一整套具有完全自主知識產(chǎn)權的鼻內(nèi)鏡手術相關的鼻腔解剖學圖譜。方法：選取經(jīng)10%甲醛溶液固定的成人尸頭10具,干性頭顱骨10例。按既定研究方法對尸頭進行精細解剖研究,分析鼻腔及相關區(qū)域結構的位置、形態(tài)、毗鄰關系。并用專業(yè)設備對鼻腔相關結構進行多方位拍攝。 結果：明確了鼻內(nèi)鏡竇口鼻道復合體區(qū)域手術、額竇區(qū)域手術、鼻眼相關區(qū)域手術、蝶鞍區(qū)域、翼腭窩顳下窩區(qū)域手術相關解剖結構的詳細形態(tài)、方位、界限及毗鄰等。 結論：1、鉤突下端附著及囟門類型、鉤突變異、篩泡及側(cè)竇的氣化類型、中鼻甲基板形態(tài)、泡甲、Haller氣房是竇口鼻道復合體區(qū)域手術定位和謹慎操作的重要結構。2、在額竇區(qū)域手術中鉤突上端附著、額隱窩形態(tài)、鼻丘氣房、額隱窩區(qū)相關氣房是影響手術操作的重要結構。3、明確上頜骨額突與淚骨的連接,鼻淚管走形及其與鼻丘氣房的關系,紙樣板、內(nèi)直肌、視神經(jīng)與篩竇、蝶竇的關系、視神經(jīng)與眼動脈的走形關系對鼻眼相關手術有重要的指導意義。4、在經(jīng)鼻蝶蝶鞍區(qū)域手術中,視神經(jīng)-頸內(nèi)動脈隱窩比視神經(jīng)隆突或頸內(nèi)動脈隆突的定位意義更顯著,蝶鞍底壁凸面是蝶竇內(nèi)定位中線的重要標志。同時,蝶竇外側(cè)壁有頸內(nèi)動脈,眼動脈,第2-6對腦神經(jīng)經(jīng)過,手術中應明確解剖結構,避免損傷導致相應的并發(fā)癥。
[Abstract]:Objective: to determine the position, shape, variation and adjacent relationship of the main anatomical structure of nasal cavity by dissection of cadaveric head, and to explore the anatomical significance of each structure in many kinds of operations under nasal endoscope. To provide the basis for the establishment of individualized surgical scheme. At the same time, a complete set of nasal anatomy atlas of nasal endoscopic surgery was made. Methods: 10 adult cadavers fixed with 10% formaldehyde solution were selected. Ten cases of dry cranial bone were dissected according to the established research method to analyze the position and shape of nasal cavity and related regional structure. Contiguous relationship. Use professional equipment to take multi-directional photographs of nasal cavity-related structures. Results: the detailed morphology and orientation of the anatomical structures related to the surgery of the nasal endoscopic sinus ostioronasal complex region, frontal sinus region, nasal eye region, Sella region and pterygopalatine fossa inferior temporal fossa were identified. Boundaries and contiguity, etc. ConclusionThe type of attachment and fontanel to the lower end of uncinate process, the mutation of hook, the type of vaporization of ethmoid vesicles and lateral sinuses, the shape of basal plate of middle turbinate, the form of vesicular nail. Haller gas chamber is an important structure of surgical location and careful operation in the region of sinooronasal complex. It is attached to the upper end of the uncinate process, the shape of frontal recess, and the nasal colliculus gas chamber in frontal sinus surgery. The related gas chamber in the frontal recess area is an important structure affecting the operation. The connection between the maxillary frontal process and the lacrimal bone, the shape of the nasolacrimal duct and its relationship with the nasal colliculus chamber, the paper template, the medial rectus muscle, the optic nerve and the ethmoid sinus are defined. The relationship between sphenoid sinus, optic nerve and ophthalmic artery has important guiding significance for naso-ocular surgery. 4, in transsphenoidal Sella region surgery. The recess of the optic nerve and internal carotid artery is more significant than the optic nerve protuberance or the internal carotid artery protuberance is an important sign of the midline of the sphenoid sinus. At the same time the lateral wall of the sphenoid sinus has the internal carotid artery and the ophthalmic artery. The anatomic structure of 2-6 pairs of brain nerves should be clearly defined during operation to avoid the corresponding complications caused by injury.
【學位授予單位】：山西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2010
【分類號】：R765

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