Barakzai Safia Z, Kane-Smyth Justine, Lowles Joanna, Townsend Neil
Easter Bush Veterinary Centre, Division of Veterinary Clinical Science, Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush, Roslin, Midlothian, Scotland, EH25 9RG, UK.
Vet Surg. 2008 Apr;37(3):278-82. doi: 10.1111/j.1532-950X.2008.00377.x.
To examine 2 rostral maxillary sinus (RMS) trephine sites for safety and efficacy using skulls of horses of varying age.
Descriptive study.
Cadaveric equine skulls (n=40).
Two RMS trephination sites (rostral, caudal) were made in each skull. Radiographic projections using markers at each site were used to determine if sites were within the RMS and directly overlying a cheek tooth. Sinusotomy in 14 skulls was used to determine correlation between radiographic and anatomic location of trephine sites, and of the rostrolateral aspect of the maxillary septum. Age-related risk of trephine site being directly over a cheek tooth was determined using logistic regression.
Trephine site was within the RMS in 98% of skulls using the rostral portal and 68% using the caudal portal. The rostral site was over a cheek tooth in 18% of skulls compared with 10% using the caudal site. There was a significant negative relationship between the trephine site overlying a tooth and horse age for rostral (P=.02) and caudal (P=.03) sites. The radiographic appearance of the maxillary septum correlated to the rostrolateral portion of the septum in 12 of 14 skulls that had sinusotomy.
The rostral RMS trephine portal is more reliable than the caudal site for entering the RMS. Horses <or=5 years are at high risk for the trephine site overlying a cheek tooth and we advise that RMS trephination in this age group be performed with radiographic guidance.
使用不同年龄马的颅骨，检查两个上颌窦前位（RMS）环锯部位的安全性和有效性。
描述性研究。
马的尸体颅骨（n = 40）。
在每个颅骨上制作两个RMS环锯部位（前位、后位）。使用每个部位的标记物进行放射摄影投影，以确定这些部位是否在上颌窦内且直接覆盖颊齿。对14个颅骨进行鼻窦切开术，以确定环锯部位的放射学位置与解剖学位置之间以及上颌中隔的前外侧部分之间的相关性。使用逻辑回归确定环锯部位直接覆盖颊齿的与年龄相关的风险。
使用前位入口时，98%的颅骨中环锯部位在上颌窦内；使用后位入口时，68%的颅骨中环锯部位在上颌窦内。前位部位在18%的颅骨中覆盖颊齿，而后位部位为10%。对于前位（P = 0.02）和后位（P = 0.03）部位，覆盖牙齿的环锯部位与马的年龄之间存在显著的负相关。在14个进行了鼻窦切开术的颅骨中，有12个上颌中隔的放射学表现与中隔的前外侧部分相关。
进入上颌窦时，前位RMS环锯入口比后位部位更可靠。年龄≤5岁的马，其环锯部位覆盖颊齿的风险较高，我们建议在该年龄组进行RMS环锯术时采用放射学引导。
