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摘要: 目的: 根据最新的蝶窦分类方法对中国人的蝶窦进行分类研究,了解中国人的蝶窦发育状况。方法: 收集100例成人蝶窦的CT检查资料,排除标准为CT显示有蝶窦病变、颅内肿瘤、颅面部解剖异常者。通过GE公司AW4.4图像后处理系统,利用MPR技术对原始图像进行x、y、z轴调整,得出标准对称的轴位、矢状位、冠状位重建图像。依最新的分类方法进行分类。结果: 中国人的蝶窦气化程度似乎有"两极分化"趋势,即气化较差的如甲介型及鞍前型占10%,而气化良好者其气化程度远高于国外。蝶体型、外侧型、小翼型、前向型均未见,而斜坡型占26.66%,混合型占73.33%,中国人蝶窦的混合型比例更高。结论: 蝶窦的不同气化程度对于各种经蝶手术操作会有重大影响,术前完善影像学检查,仔细对其进行分型,不仅有利于判断蝶窦的气化程度、分型,而且可以很好地明确蝶窦周围的重要血管、神经结构,甚至有助于判别其解剖标志,对于各种经蝶手术有极大帮助。Abstract: Objective: To examine various pneumatized extensions of the sphenoid sinus of Chinese people.Method: The sphenoid sinus and its surrounding structures were examined from 100 computed tomography images of the sinus. The type of the sphenoid sinus was classified according to the various extensions of the sinus.Result: The type of the sphenoid sinus was classified into the following 6 basic types based on the direction of pneumatization:sphenoid body, lateral, clival, lesser wing,anterior, and combined.Conclusion: The variations in the extensions of pneumatization of the sphenoid sinus may facilitate entry into areas bordering the sphenoid sinus.
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Key words:
- sphenoid sinus /
- X-computed /
- tomography
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[1] 陆书昌,范静平,廖建春,等.内窥镜蝶窦及蝶鞍区手术应用解剖学研究[J].中国临床解剖学杂志,1996,14(2):95-98.
[2] FRAIOLI B,ESPOSITO V,SANTORO A,et al.Transmaxillosphenoidal approach to tumors invading the medial compartment of the cavernous sinus[J].J Neurosurg,1995,82:63-69.
[3] CAPPABIANCA P,BRIGANTI F,CAVALLO L M,et al.Pseudoaneurysm of the intracavernous carotid artery following endoscopic endonasal transsphenoidal surgery,treated by endovascular approach[J].Acta Neurochir(Wien),2001,143:95-96.
[4] CAPPABIANCA P,CAVALLO L M,DE DIVITIIS E.Endoscopic endonasal transsphenoidal surgery[J].Neurosurgery,2004,55:933-940.
[5] CAPPABIANCA P,CAVALLO L M,ESPOSITO F,et al.Extended endoscopic endonasal approach to the midline skull base:the evolving role of transsphenoidal surgery[J].Adv Tech Stand Neurosurg,2008,33:151-199.
[6] CAVALLO L M,CAPPABIANCA,P,MESSINA A,et al.The extended endoscopic endonasal approach to the clivus and cranio-vertebral junction:anatomical study[J].Childs Nerv Syst,2007,23:665-671.
[7] CAVALLO L M,DE DIVITIIS O,AYDIN S,et al.Extended endoscopic endonasal transsphenoidal approach to the suprasellar area:anatomic considerations-part 1[J].Neurosurgery,2008,62:1202-1212.
[8] DE DIVITIIS E,CAVALLO L M,CAPPABIANCA P,et al.Extended endoscopic endonasal transsphenoidal approach for the removal of suprasellar tumors:Part 2[J].Neurosurgery,2007,60:46-58.
[9] DE DIVITIIS E,CAPPABIANCA P,CAVALLO L M,et al.Extended endoscopic transsphenoidal approach for extrasellar craniopharyngiomas[J].Neurosurgery,2007,61:219-227.
[10] KASSAM A,SNYDERMAN C H,MINTZ A,et al.Expanded endonasal approach:the rostrocaudal axis.PartⅠ.Crista galli to the sella turcica[J].Neurosurg Focus,2005,19:E3-E3.
[11] KASSAM A B,THOMAS A J,ZIMMER L A,et al.Expanded endonasal approach:a fully endoscopic completely transnasal resection of a skull base arteriovenous malformation[J].Childs Nerv Syst,2007,23:491-498.
[12] MASON R B,NIEMAN L K,DOPPMAN J L,et al.Selective excision of adenomas originating in or extending into the pituitary stalk with preservation of pituitary function[J].J Neurosurg,1997,87:343-351.
[13] 冯国栋,高志强,沈鹏,等.经鼻内镜蝶鞍区手术蝶窦壁的应用解剖[J].中国耳鼻咽喉头颈外科,2009,16(1):35-38.
[14] WANG J,BIDARI S,INOUE K,et al.Extensions of the sphenoid sinus:a new classification[J].Neurosurgery,2010,66:797-816.
[15] JHO H D.Endoscopic transsphenoidal surgery[J].J Neurooncol,2001,54:187-195.
[16] PREVEDELLO D M,DOGLIETTO F,JANE J J,et al.History of endoscopic skull base surgery:its evolution and current reality[J].J Neurosurg,2007,107:206-213.
[17] 刘卫平,伊西才,魏礼洲,等.内镜颅底外科[J].中华脑科疾病与康复杂志(电子版),2013,3(1):5-8.
[18] 王翦,BIDARI S,RHOTON A.蝶窦外侧壁的显微解剖及其在扩大经蝶手术中的应用[J].中国神经肿瘤杂志,2009,7(3):180-183.
[19] 赵振华,王启荣,刘树伟,等.蝶窦冠状位薄层断层解剖学研究[J].山东大学耳鼻喉眼学报,2010,24(1):35-37.
[20] 石海平,曾春,段佳,等.内镜辅助下经鼻腔蝶窦入路垂体瘤切除术的安全性分析[J].中国肿瘤临床与康复,2014,21(7):867-869.
[21] 刘斯润,黄力.蝶筛窦形态变异及其在Waters'和侧位片上投影(附250例CT、X线平片对照分析)[J].中国医学影像技术,2000,16(10):826-828.
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