Hidir Yusuf, Battal Bilal, Durmaz Abdullah, Karaman Bulent, Tosun Fuat
Department of Otorhinolaryngology-Head and Neck Surgery, Gulhane Military Medical Academy, Ankara, Turkey.
J Craniofac Surg. 2011 May;22(3):1077-9. doi: 10.1097/SCS.0b013e31821075c1.
The purpose of this study was to investigate the optimum height that the sphenoid sinus ostium can be probed safely from the roof of choana in a large group of patients.
The study was performed retrospectively. The 200 sphenoid ostia of the 100 patients whose thin-section computed tomography (CT) including the sphenoid sinus region, made for various reasons, were included in the study. The height of the sphenoid ostium and the skull base from the choana roof were measured on sagittal images of CT. Also, by calculating the ratio of first measurement to the second one, the location of the sphenoid ostium at the anterior wall of sphenoid sinus was determined proportionally.
The mean height of the sphenoid ostium from the choana roof was 10.9 (SD, 2.3) mm (range, 5.7-21.5 mm), and the mean height of skull base along the anterior wall of sphenoid sinus from the choana roof was 21.3 (SD, 3.2) mm (range, 13.3-30.6 mm). The ratio of the first measurement to the second measurement was 0.5 (SD, 0.08) (range, 0.29-0.77).
In conclusion, under endoscopic view, the sphenoid sinus ostium can be safely probed between 13.3 mm (the minimum skull base height) and 5.7 mm (the minimum sphenoid sinus ostium height) distance upward from the choana, but determining the height of the sphenoid sinus ostium preoperatively on CTs for each patient separately will increase the chance of success in probing the sphenoid sinus.
本研究旨在调查在一大组患者中，从后鼻孔顶部安全探测蝶窦开口的最佳高度。
本研究为回顾性研究。纳入100例因各种原因进行了包括蝶窦区域的薄层计算机断层扫描（CT）的患者的200个蝶窦开口。在CT矢状位图像上测量蝶窦开口与后鼻孔顶部之间的高度以及蝶窦前壁处颅底与后鼻孔顶部之间的高度。此外，通过计算第一次测量值与第二次测量值的比值，按比例确定蝶窦开口在蝶窦前壁的位置。
蝶窦开口距后鼻孔顶部的平均高度为10.9（标准差，2.3）mm（范围为5.7 - 21.5 mm），蝶窦前壁处颅底沿后鼻孔顶部的平均高度为21.3（标准差，3.2）mm（范围为13.3 - 30.6 mm）。第一次测量值与第二次测量值的比值为0.5（标准差，0.08）（范围为0.29 - 0.77）。
总之，在内镜观察下，从后鼻孔向上13.3 mm（最小颅底高度）至5.7 mm（最小蝶窦开口高度）的距离之间可安全探测蝶窦开口，但针对每位患者在术前CT上单独确定蝶窦开口的高度将增加探测蝶窦成功的几率。
