Department of Otolaryngology, First Affiliated Hospital, and Otolaryngology Institute, Sun Yat-Sen University, Guangzhou, Guangdong, People's Republic of China.
Laryngoscope. 2010 Jul;120(7):1298-302. doi: 10.1002/lary.20958.
OBJECTIVES/HYPOTHESIS: Nasopharyngectomy for residual/recurrent nasopharyngeal carcinoma (NPC) using an endoscopic technique is less invasive than traditional methods. Our objective was to identify the important anatomic landmarks so that the endoscopic surgeon can avoid injury to the internal carotid artery and perform a nasopharyngectomy safely.
Anatomical study.
Transnasal endoscopic dissection was carried out on three fresh adult cadaver specimens (six sides) after arterial latex injection. Measurements were made in 50 adult skulls (100 sides), detailing the distances between orienting critical landmarks and the internal carotid canal (external aperture).
Adequate exposure for endoscopic nasopharyngectomy is available by removing portions of the inferior turbinate, nasal septum, and medial pterygoid plate. Anatomy of the operative field (endoscopic view) is described. Orientating topical landmarks include: posterior portions of the inferior turbinate and nasal septum, fossa of Rosenmuller, and the torus tubarius. The deep landmarks include: medial pterygoid plate-posterior margin at the skull base, eustachian tube isthmus, foramen lacerum, and the longus capitis. All topical and deep landmarks were identified from the endoscopic point of view and their distances to the internal carotid canal (external aperture) were measured.
This anatomic study provides novel orienting landmarks for endoscopic nasopharyngectomy. Surgeons can efficiently and safely deal with residual and/or recurrent NPC endoscopically.
目的/假设：经鼻内镜切除残留/复发性鼻咽癌（NPC）比传统方法创伤更小。我们的目的是确定重要的解剖标志，以便内镜外科医生能够避免损伤颈内动脉，并安全地进行咽切除术。
解剖学研究。
经鼻内镜解剖在 3 例新鲜成人尸体标本（6 侧）上进行，标本在动脉乳胶注射后进行。对 50 例成人颅骨（100 侧）进行了测量，详细记录了定向关键标志与颈内动脉管（外口）之间的距离。
通过切除下鼻甲、鼻中隔和翼内板的部分，可以获得足够的内镜咽切除术暴露。描述了手术区域的解剖结构（内镜视图）。定向的表面标志包括：下鼻甲和鼻中隔的后部、Rosenmuller 窝和咽鼓管隆突。深部标志包括：翼内板-颅底后缘、咽鼓管峡部、破裂孔和头长肌。所有表面和深部标志均从内镜角度识别，并测量了它们与颈内动脉管（外口）的距离。
这项解剖学研究为经鼻内镜咽切除术提供了新的定向标志。外科医生可以高效、安全地处理残留和/或复发性 NPC。
