Gao Li, Zhou Lei, Dai Zhengshou, Huang Xinsheng
*Department of Otolaryngology-Head and Neck Surgery, Shanghai Zhongshan Hospital Affiliated to Fudan University †Department of Human Anatomy and Histoembryology, Fudan University, Shanghai, China.
J Craniofac Surg. 2017 Sep;28(6):1589-1593. doi: 10.1097/SCS.0000000000003419.
The authors studied the anatomic importance of the endoscopic prelacrimal recess approach (PLRA) to the pterygopalatine fossa (PPF) and infratemporal fossa (ITF).
Ten adult heads (20 sides) from cadavers fixed in formalin were dissected using the PLRA. Anatomic dissections were detailed and several crucial landmarks measured.
Identification of the infraorbital neurovascular bundle is the crucial step for the detection of other branches of the maxillary artery. The distance from the base of columella to inferior orifice of the nasolacrimal duct, sphenopalatine foramen, pterygold canal, foramen rotundum, foramen ovale was (32.97 ± 3.44), (63.93 ± 4.52), (66.81 ± 3.44), (68.13 ± 4.43), and (85.23 ± 6.25) mm, respectively. The PLRA can be used to expose the entire maxillary sinus and PPF, most parts of the ITF (lateral pterygoid muscle, foramen ovale, mandibular division of the trigeminal nerve, and its divisions), maxillary artery and its branches, and the superior part of the medial pterygoid muscle (upon the floor of the maxillary sinus). The lateral boundary can be reached to visualize the temporomandibular joint and vertically oriented temporalis muscle.
Use of the PLRA to the PPF and ITF offers a clear visual field, wide range of exposure, as well as preservation of the integrity of nasal structures.
作者研究了经鼻内镜泪前隐窝入路（PLRA）至翼腭窝（PPF）和颞下窝（ITF）的解剖学意义。
使用PLRA对10个用福尔马林固定的成人尸体头部（20侧）进行解剖。详细进行解剖并测量了几个关键标志。
识别眶下神经血管束是检测上颌动脉其他分支的关键步骤。从鼻小柱基部至鼻泪管下口、蝶腭孔、翼管、圆孔、卵圆孔的距离分别为（32.97±3.44）、（63.93±4.52）、（66.81±3.44）、（68.13±4.43）和（85.23±6.25）mm。PLRA可用于暴露整个上颌窦和PPF、ITF的大部分（翼外肌、卵圆孔、三叉神经下颌支及其分支）、上颌动脉及其分支以及翼内肌的上部（在上颌窦底）。可到达外侧边界以观察颞下颌关节和垂直方向的颞肌。
使用PLRA至PPF和ITF可提供清晰的视野、广泛的暴露范围，并能保持鼻腔结构的完整性。
