本文選題：CT仿真內(nèi)窺鏡　切入點(diǎn)：上頜竇　出處：《中國(guó)醫(yī)科大學(xué)》2010年碩士論文　論文類型：學(xué)位論文

【摘要】： 目的 利用CT仿真內(nèi)窺鏡觀察上頜竇手術(shù)各種入路下的視野范圍,并通過測(cè)量及描述不同入路的視野范圍,尋求不同手術(shù)入路聯(lián)合,擴(kuò)大手術(shù)視野,去除死角,徹底清除病變的方法,從而探討CT仿真內(nèi)窺鏡在上頜竇手術(shù)中的臨床應(yīng)用價(jià)值。 材料和方法 選取3例成人尸頭共6個(gè)上頜竇竇腔作為標(biāo)本,清潔并沖凈上頜竇竇腔后分別進(jìn)行CT掃描,利用仿真內(nèi)窺鏡系統(tǒng)模擬0度鼻內(nèi)鏡,對(duì)標(biāo)本進(jìn)行三種上頜竇手術(shù)進(jìn)路(經(jīng)犬齒窩上頜竇前壁入路,經(jīng)中鼻道入路,經(jīng)下鼻道入路)的視野觀察,確認(rèn)并描述上頜竇手術(shù)各種入路下的視野范圍,并找出不同標(biāo)本上頜竇竇腔視野范圍之間的區(qū)別。 結(jié)果 經(jīng)標(biāo)準(zhǔn)上頜竇前壁開窗即柯陸氏入路的仿真內(nèi)窺鏡模擬0°鼻內(nèi)鏡檢查：視野范圍較大,可檢查到整個(gè)后壁,大于1／2的內(nèi)側(cè)壁、外側(cè)壁、頂壁及底壁,小于1／2的前壁。視野死角主要為臨近開窗口的前壁以及小部分的內(nèi)側(cè)壁。對(duì)于氣化不良的上頜竇腔,可窺清整個(gè)竇腔。中鼻道入路及下鼻道入路視野范圍較局限,相互聯(lián)合可擴(kuò)大視野,可窺及大部分后壁,小部分的頂壁和外壁,前壁、底壁及內(nèi)壁均無法窺及。 結(jié)論 不同形狀的上頜竇竇腔在CT仿真內(nèi)窺鏡模擬0度鼻內(nèi)鏡下觀察得到的視野范圍具有差異性。CT仿真內(nèi)窺鏡具有無創(chuàng)性,能清晰地顯示上頜竇竇腔結(jié)構(gòu),逼真地模擬鼻竇鏡檢查及手術(shù),可以根據(jù)上頜竇竇腔的具體情況選擇最佳的手術(shù)方案,使徹底清除上頜竇病變成為了可能,在鼻內(nèi)鏡下上頜竇手術(shù)領(lǐng)域有很好的應(yīng)用價(jià)值及廣闊的前景。
[Abstract]:Purpose. Using CT virtual endoscope to observe the range of visual field under various approaches of maxillary sinus surgery, and by measuring and describing the range of visual field of different approaches, seeking the combination of different operative approaches, expanding the operative field of vision and removing dead angle. To evaluate the clinical value of CT virtual endoscopy in maxillary sinus surgery. Materials and methods. A total of 6 maxillary sinuses were collected from 3 adult cadavers. After cleaning and cleaning the maxillary sinus cavity, CT scanning was performed respectively, and a virtual endoscope system was used to simulate 0 degree nasal endoscopy. The visual field of three kinds of maxillary sinus surgical approaches (anterior canine sinus approach, middle nasal approach, inferior nasal approach) were observed to confirm and describe the visual field of maxillary sinus surgery. The difference of the visual field of maxillary sinus cavity between different specimens was found out. Results. Virtual endoscopy through the standard maxillary antral wall fenestration, I. e., Calder's approach, simulated 0 擄nasal endoscopy: the visual field is large, the entire posterior wall can be detected, the medial wall, lateral wall, parietal wall and bottom wall are larger than 1/2. The dead angle of visual field is mainly the anterior wall adjacent to the open window and a small part of the medial wall. For the maxillary sinus cavity with poor gasification, the entire sinus cavity, the middle nasal approach and the inferior nasal approach are more limited. Combined with each other, the vision can be extended to most of the posterior wall, a small part of the apical wall and the outer wall, the anterior wall, the bottom wall and the inner wall can not be peered out. Conclusion. Different shapes of maxillary sinus cavity were observed under CT virtual endoscope under 0 degree nasal endoscopy. Ct virtual endoscopy was noninvasive and could clearly display the structure of maxillary sinus cavity. Realistic simulation of paranasal sinus examination and surgery, according to the specific conditions of the maxillary sinus cavity can choose the best surgical plan, so that the complete removal of maxillary sinus lesions became possible. It has good application value and broad prospect in the field of maxillary sinus surgery under nasal endoscope.
【學(xué)位授予單位】：中國(guó)醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2010
【分類號(hào)】：R765.9
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本文編號(hào)：1619686