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目的探讨蝶窦前壁区的解剖特征及其在经蝶窦入路手术中的意义。方法用15例(30侧)成人头部标本及20例(40侧)成人头骨标本,在手术显微镜下对蝶窦前壁骨质、蝶腭动脉及其分支等结构进行观察和测量。结果蝶窦前壁的基本形态酷似鸟头,正中线棱状高起,两侧为鸟眼样的蝶窦口,下方为鸟喙样的蝶嘴。蝶窦口距上鼻道末端(14.5±1.1)mm,距后鼻孔上缘(12.2±1.0)mm,距鼻后中隔动脉上支(8.2±0.5)mm。自鼻孔伸入探条探测蝶窦前壁时,所探及的“最浅点”大致位于蝶窦口与后鼻孔之间的中点附近。蝶腭孔位于蝶窦口的外下方和中鼻甲的后端区域,与蝶窦口间距(6.9±1.3)mm,两侧蝶腭孔内侧缘间距(18.2±2.5)mm。结论蝶窦前壁具有特征性的形态,蝶窦口大致位于蝶窦前壁的上中1/3交界处,其下方的骨质向前方突起。蝶腭孔位于蝶窦口下外侧方约7 mm处,经蝶窦入路手术中可以依此定位蝶腭孔。
Objective To explore the anatomical characteristics of anterior sphenoid antrum and its significance in transsphenoidal surgery. Methods Fifteen cases (30 sides) of adult head specimens and 20 cases (40 sides) of adult skull specimens were observed and measured under the operation microscope on the anterior wall of sphenoid sinus, sphenopalatine artery and its branches. Results The anterior wall of the sphenoid sinus resembles the bird head with the bird’s head just like the bird’s head. The sphenoid sinus ostium was (14.5 ± 1.1) mm distal to the superior nasal passages, (12.2 ± 1.0) mm posterior to the posterior nasal passages and (8.2 ± 0.5) mm superior to the posterior nasal septum. From the nostril into the probe to detect the sphenoid sinus anterior wall, the exploration of the “shallowest point ” is located approximately in the midpoint between the sphenoid sinus and posterior nostril. The sphenopalatine foramen was located outside the sphenoid ostium and in the posterior region of the middle turbinate, with a distance of 6.9 ± 1.3 mm from the sphenoid sinus ostium and a distance of 18.2 ± 2.5 mm between the medial margins of the sphenopalatine foramen. Conclusion The anterior wall of the sphenoid sinus has the characteristic morphology. The sphenoid sinus ostium is located approximately at the middle 1/3 of the anterior wall of the sphenoid sinus, and the bone below it protrudes forward. The sphenopalatine fossa is located about 7 mm lateral to the lateral sphenoid ostium, and the sphenopalatine foramen can be positioned by transsphenoidal approach.