Department of Otolaryngology, Head and Neck Surgery, Hospital of Shenzhen University, Health science center, Shenzhen Second People's Hospital, Shenzhen, China.
Department of Emergency Ward and Intensive Care Unit, Hospital of Shenzhen University, Health science center, Shenzhen Second People's Hospital, Shenzhen, China.
J Anat. 2019 Aug;235(2):246-255. doi: 10.1111/joa.13009. Epub 2019 May 9.
The vomerovaginal canal (VVC) and palatovaginal canal (PVC) are two canals that open forward to the posterior wall of the pterygopalatine fossa (PPF). Although the anatomy and computed tomography (CT) appearances of the PVC have been well studied, the VVC has been rarely reported, especially in endoscopic examinations. Some studies have even failed to distinguish the PVC from the VVC on CT images. The purpose of this study was to demonstrate the anatomy of the VVC on endoscopy and reveal its differences from the PVC, and to analyse the relative positions of the VVC, PVC, and pterygoid canal on CT images. Ten dry skull bases were studied to observe the structures involved in the formation of the VVC. Dissection of four cadaveric heads was performed to demonstrate the anatomy of the VVC on endoscopy. Coronal CT image analysis in 70 patients was conducted to evaluate the distances and relative positions between the VVC, PVC, and pterygoid canal. The PVC and VVC were also compared on axial CT images. The osteological study showed the top wall of the VVC was the antero-inferior wall of the sphenoid sinus. The VVC may be a helpful landmark in endoscopic endonasal transpterygoid approaches. Steps and discrimination in the dissections of the VVC and PVC were described. The interval between the PVC and VVC could be observed on both coronal and axial CT images. The coronal CT images of patients showed differences in the positions and distances among the three canals at both the anterior and posterior apertures of the PVC. The VVC can be easily mistaken for the PVC if its existence is not suspected. The anatomical morphologies and trajectories of the VVC and PVC differed on both nasal endoscopy and CT. The existence of the VVC should be considered during surgery and CT diagnosis within this area.
阴道穹窿-阴道后腔（VVC 和 PVC）是两条向前开口于翼腭窝（PPF）后壁的管道。尽管 PVC 的解剖结构和 CT 表现已经得到了很好的研究，但 VVC 却很少被报道，尤其是在内窥镜检查中。一些研究甚至未能在 CT 图像上区分 PVC 和 VVC。本研究旨在通过内窥镜观察 VVC 的解剖结构，揭示其与 PVC 的差异，并分析 VVC、PVC 和翼管在 CT 图像上的相对位置。研究了 10 个干颅骨基底以观察形成 VVC 的结构。对 4 个头颅标本进行解剖以展示内窥镜下 VVC 的解剖结构。对 70 例患者的冠状 CT 图像进行分析，以评估 VVC、PVC 和翼管之间的距离和相对位置。还对轴向 CT 图像进行了 PVC 和 VVC 的比较。骨骼研究显示 VVC 的顶壁是蝶窦的前下壁。VVC 可能是经鼻内镜经翼突入路的有用标志。描述了 VVC 和 PVC 的解剖步骤和区别。在冠状和轴向 CT 图像上都可以观察到 PVC 和 VVC 之间的间隔。患者的冠状 CT 图像显示，在 PVC 的前、后口处，三个管道的位置和距离存在差异。如果不怀疑 VVC 的存在，VVC 很容易被误认为是 PVC。VVC 和 PVC 的解剖形态和轨迹在鼻内窥镜和 CT 上都有所不同。在该区域的手术和 CT 诊断中应考虑 VVC 的存在。
