摘要
目的：为筛、蝶窦手术中筛动脉管(the ethmoidal canal)及视神经管(the optic
canal)的定位提供客观资料和数据，进而了解内窥镜下筛窦、蝶筛区域的解剖结构。方法：经鼻内窥镜对15具湿性成人无脑尸头30侧筛、蝶窦解剖，观察筛顶及筛窦外侧壁、蝶筛区域的解剖结构，对筛动脉筛窦段、视神经管段进行观察和测量。结果：1．①15具30侧均找到筛前动脉管。13具25侧找到筛后动脉管，2具未见筛后动脉管，1具右侧未见筛后动脉管。有8侧筛前动脉管(26.7％)走行于筛窦顶壁内，18侧筛前动脉管(60％)突入筛房内走行，4侧(13.33％)走行于筛房内。6侧筛后动脉管(20％)见到有分支而筛前动脉均未见有分支。②筛前动脉管距鼻小柱和鼻翼交界点(the joint of columella nasi and alae nasi)的平均距离左侧为60.1±3.45(55.2～66.3)mm，右侧为60.1±3.20(55.3～65.8)mm，个体间最大差距为11.1mm。筛后动脉管与鼻小柱和鼻翼交界点的平均距离左侧为67.3±2.15(62.2～72.7)mm，右侧为67.6±1.75(61.6～73.5)mm，个体间最大差距为11.9mm；2．①视神经骨管类型及其内侧壁的毗邻关系与国内外学者观察基本相似；②视神经管眶口与鼻小柱和鼻翼交界处左侧的距离为77.90±1.65(74.8～81.0)mm，其右侧距离为77.65±1.77(74.2～80.8)mm；视神经管颅口与鼻小柱和鼻翼交界处左侧的距离为83.80±2.14(80.2～86.8)mm，其右侧距离为83.38±2.36(79.4～86.4)mm。视神经管眶口、颅口与鼻小柱和鼻翼交界处距离的个体标本间最大相差值分别为6.6mm和7.0mm。结论：①临床手术中筛动脉管和视神经管的准确定位具有重要意义。②有部分筛前动脉管突入或走行于筛窦内，增加了术中损伤率。③视神经骨管与筛蝶窦侧壁的毗邻关系复杂。
Objective: To provide objective data for the location of the ethmoidal canal and optic canal in ethmoidectomy. Method: 30 temporal ethmoidals in 15 cadavers were dissected endoscopically, the intraethmoidal parts of ethmoidal canal and optic canal were observed and measured. Results: 1.(1) All cases the anterior ethmoidal canal were found, in 25 of 30 the posterior ethmoidal canal were obervered. In 8 of 30 cases AEC was attached to the base of the skull, 18 of 30 cases bulging into the anterior ethmoid sinus, and in the remaining 4 cases it ran below the skull base. (2) The median distance between anterior ethmoidal canal and the joint of columella nasi and alae nasi is 60.1 3.45 (range 55.2~66.3 )mm on the left side and 60.1 3.20(range 55.3~65.8)mm on the right side, interindividual distance is up to 11.1mm.that of posterior ethmoidal canal and the joint of columella nasi and alae nasi was 67.3 2.15(range 62.2~72.7)mm on the left side and 67.6 1.75(range 61.6~73.5)mm on the right side, interindividual dist
ance is up to 11.9mm. 2.(1) The type of the optic canal and the adjacent structures of inner wall of the optic canal were observed that were alike to the others' observation.(2) The median distance between the joint of columella nasi and alae nasi and the eye socket meatus of optic canal is 77.90 1.65 (range 74.8~ 81.0) mm mm on the left side and 77.65 1.77(range 74.2~80.8)mm on the right side; that and the encephalic meatus of optic canal is 83.80 2.14 (range 80.2~86.8) mm on the left side and 83.38 2.36 (range 79.4~86.4) mm on the right side, interindividual distance are up to 6.6
and 7.0mm. Conclusions: CD Endoscopic localization of the ethmoidal canal and the optic canal are of importance in ethmoidectomy. (2) Partial the anterior ethmoidal canal bulge into the anterior ethmoid sinus or ran below the skull base which results in more injures. (3) The adjacent structures of inner wall of the optic canal was complicated.
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