Açar Gülay, Çiçekcibaşı Aynur Emine, Çukurova İbrahim, Özen Kemal Emre, Şeker Muzaffer, Güler İbrahim
Necmettin Erbakan University, Meram Faculty of Medicine, Department of Anatomy, Konya, Turkey.
Necmettin Erbakan University, Meram Faculty of Medicine, Department of Anatomy, Konya, Turkey.
Braz J Otorhinolaryngol. 2019 Mar-Apr;85(2):136-143. doi: 10.1016/j.bjorl.2017.11.008. Epub 2017 Dec 26.
The type of endoscopic approach chosen for vidian neurectomy can be specified by evaluating the vidian canal and the surrounding sphenoid sinus structures.
The variations and morphometry of the vidian canal were investigated, focusing on the functional correlations between them which are crucial anatomical landmarks for preoperative planning.
This study was performed using paranasal multidetector computed tomography images that were obtained with a section thickening of 0.625mm of 250 adults.
The distributions of 500 vidian canal variants were categorized as follows; Type 1, within the sphenoid corpus (55.6%); Type 2, partially protruding into the sphenoid sinus (34.8%); Type 3, within the sphenoid sinus (9.6%). The pneumatization of the pterygoid process is mostly seen in vidian canal Type 2 (72.4%) and Type 3 (95.8%) (p<0.001). The mean distances from the vidian canal to the foramen rotundum and the palatovaginal canal were greater in the vidian canal Type 2 and 3 with the pterygoid process pneumatization (p<0.001). The prevalence of the intrasphenoid septum between the vidian canal and the vomerine crest and lateral attachment which ending on carotid prominence were much higher in vidian canal Type 3 than other types (p<0.001). The mean angle between the posterior end of the middle turbinate and the lateral margin of the anterior opening of the vidian canal was measured as 33.05±7.71°.
Preoperative radiologic analysis of the vidian canal and the surrounding structures will allow surgeons to choose an appropriate endoscopic approach to ensure predictable postoperative outcomes.
通过评估翼管和周围蝶窦结构，可以确定翼管神经切断术所选用的内镜入路类型。
研究翼管的变异和形态测量，重点关注它们之间的功能相关性，这些相关性是术前规划的关键解剖标志。
本研究使用了250名成年人的鼻窦多层螺旋计算机断层扫描图像，扫描层厚为0.625毫米。
500个翼管变异的分布分类如下：1型，位于蝶骨体部（55.6%）；2型，部分突入蝶窦（34.8%）；3型，位于蝶窦内（9.6%）。翼突气化多见于翼管2型（72.4%）和3型（95.8%）（p<0.001）。翼管2型和3型伴有翼突气化时，翼管至圆孔和腭鞘管的平均距离更大（p<0.001）。翼管3型中，翼管与犁骨嵴和止于颈动脉隆突的外侧附着之间的蝶窦内隔的发生率远高于其他类型（p<0.001）。中鼻甲后端与翼管前口外侧缘之间的平均角度为33.05±7.71°。
术前对翼管及其周围结构进行影像学分析，将有助于外科医生选择合适的内镜入路，以确保可预测的术后结果。
