Department Otolaryngology Head and Neck Surgery, Luzerner Kantonsspital, Lucerne, Swtizerland.
Rhinology. 2010 Sep;48(3):364-7. doi: 10.4193/Rhino09.136.
Profound knowledge of the surgical anatomy is required to perform any dacryo-cysto-rhinostomy (DCR) procedure. In endoscopic endonasal DCR surgery, the uncinate process (UP) and/or agger nasi (AN) cell are frequently found to obstruct access to the lacrimal fossa. The aim of this study was to analyse the radiological anatomy of the UP and the AN cell in relation to the lacrimal sac.
Preoperative computed tomography (CT) scans of patients undergoing DCR and other endoscopic sinus surgeries were analysed regarding their anatomical variations concerning the UP and the AN cell at the level of the common canaliculus. The covering of the lacrimal fossa by the UP was graded and a surgically relevant AN cell was sought after.
CT datasets of 60 sides were included. Analysis showed an AN cell overlying the upper parts of the lacrimal sac in 55% of patients. An anteriorly attaching UP covering at least 50% of the lacrimal fossa was found in 63% of individuals.
In this study more than 80% of all patients presented with either a very anteriorly attached UP or an AN cell that would have to be removed to perform effective endoscopic DCR. The AN cell and the UP need to be included in the endonasal surgical concept.
要进行任何泪囊鼻腔吻合术（DCR），都需要对手术解剖学有深入的了解。在鼻内镜下经鼻内 DCR 手术中，常发现钩突（UP）和/或上颌窦自然开口（AN）细胞妨碍进入泪囊窝。本研究旨在分析 UP 和 AN 细胞与泪囊的放射解剖关系。
对接受 DCR 和其他鼻内镜鼻窦手术的患者的术前计算机断层扫描（CT）进行分析，以了解其在共同鼻道水平上的 UP 和 AN 细胞的解剖变异。对 UP 覆盖泪囊的程度进行分级，并寻找有手术意义的 AN 细胞。
共纳入 60 侧 CT 数据集。分析显示，55%的患者 AN 细胞覆盖在上部泪囊上。63%的个体有至少 50%的前部附着 UP 覆盖泪囊窝。
在这项研究中，超过 80%的患者要么是非常前部附着的 UP，要么是 AN 细胞需要切除，以进行有效的鼻内镜 DCR。AN 细胞和 UP 需要包含在鼻内手术概念中。
