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鼻腔筛动脉的放射学研究及其与内镜外科医生的相关性

Radiological Study of the Ethmoidal Arteries in the Nasal Cavity and Its Pertinence to the Endoscopic Surgeon.

作者信息

Kho Jasmine P Y, Tang Ing Ping, Tan Kia Sing, Koa Ai Jiun, Prepageran Narayanan, Rajagopalan Raman

机构信息

1Department of ENT, University Malaya Medical Centre, Kuala Lumpur, Malaysia.

2ORL-HNS Department, Faculty of Medicine and Health Sciences, University Malaysia Sarawak, Kota Samarahan, Sarawak Malaysia.

出版信息

Indian J Otolaryngol Head Neck Surg. 2019 Nov;71(Suppl 3):1994-1999. doi: 10.1007/s12070-018-1415-3. Epub 2018 Jun 2.

Abstract

We studied the ethmoidal arteries using preexisting computer tomography of the paranasal sinuses (CT PNS) and statistically scrutinized data obtained between genders. A descriptive study from 77 CT PNS dated January 2016-December 2016 were collected and reviewed by two radiologists. A total of 54 (108 sides) CT PNS were studied of patients aged 18-77 years. 37 are male, 17 are female; with Bumiputera Sarawak predominance of 25 patients, 12 Malays, 16 Chinese and one Indian. Rate of identification are as follows: anterior ethmoidal artery (AEA)-100%, middle ethmoidal artery (MEA)-30%, posterior ethmoidal artery (PEA)-86%. The average distance from AEA-MEA is 8.1 ± 1.52 mm, MEA-PEA is 5.5 ± 1.29 mm and AEA-PEA is 12.9 ± 1.27 mm. The mean distance from PEA-the anterior wall of sphenoid is 7.7 ± 3.96 mm, and PEA-optic canal is 8.5 ± 3.1 mm with no statistical difference when compared between gender. AEA frequently presented with a long mesentery 57.4%, while 87.1% of PEA was hidden in a bony canal. The vertical distance of the AEA-skull base ranges from 0 to 12.5 mm whilst PEA-skull base is 0-4.7 mm. There is no statistical difference in distances of AEA, MEA nor PEA to skull base when analyzed between genders; t(82) = 1.663,  > 0.05, t(32) = 0.403,  > 0.05 and t(75) = 1.333,  > 0.05 respectively. We newly discovered, that 50% of MEA is hidden in a bony canal, and its distance to skull base ranged 0-5.3 mm. MEA and PEA less commonly have a short or long mesentery. Knowledge on the ethmoidal arteries especially in our unstudied population of diverse ethnicity, gains to assist surgeons worldwide, when embarking in endoscopic transnasal surgeries.

摘要

我们利用现有的鼻窦计算机断层扫描(CT PNS)对筛动脉进行了研究,并对不同性别获得的数据进行了统计学审查。收集了2016年1月至2016年12月期间77例CT PNS的描述性研究资料,并由两位放射科医生进行了审查。共研究了54例(108侧)年龄在18 - 77岁患者的CT PNS。其中男性37例,女性17例;以砂拉越土著为主,共25例,12例马来人,16例华人,1例印度人。识别率如下:筛前动脉(AEA)- 100%,筛中动脉(MEA)- 30%,筛后动脉(PEA)- 86%。AEA与MEA的平均距离为8.1±1.52毫米,MEA与PEA的平均距离为5.5±1.29毫米,AEA与PEA的平均距离为12.9±1.27毫米。PEA至蝶窦前壁的平均距离为7.7±3.96毫米,PEA至视神经管的平均距离为8.5±3.1毫米,不同性别之间比较无统计学差异。AEA常出现长系膜的比例为57.4%,而87.1%的PEA隐藏在骨管内。AEA至颅底的垂直距离为0至12.5毫米,而PEA至颅底的垂直距离为0至4.7毫米。不同性别分析时,AEA、MEA和PEA至颅底的距离无统计学差异;t(82) = 1.663,> 0.05,t(32) = 0.403,> 0.05,t(75) = 1.333,> 0.05。我们新发现,50%的MEA隐藏在骨管内,其至颅底的距离为0至5.3毫米。MEA和PEA较少出现短系膜或长系膜。了解筛动脉知识,尤其是在我们未研究过的不同种族人群中,有助于全球外科医生开展鼻内镜手术。

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