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基于多排螺旋计算机断层扫描的筛窦顶壁形态测量分析在内镜鼻窦手术中的应用

The Morphometric Analysis of the Ethmoid Roof for Endoscopic Sinus Surgery With Multidetector Computed Tomography.

作者信息

Acar Musa, Şeker Büşra, Uğur Sultan

机构信息

Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Necmettin Erbakan University.

Department of Anatomy, Faculty of Medicine, Necmettin Erbakan University, Konya.

出版信息

J Craniofac Surg. 2024 Aug 30. doi: 10.1097/SCS.0000000000010589.

Abstract

Most potential major complications in endoscopic sinus surgery are related to the ethmoid bone. To prevent complications, it is necessary to define the concept of a "dangerous ethmoid." The coronal multidetector computed tomography (MDCT) scans of a total of 271 patients, including 101 patients under 18 years old and 170 patients over 18 years old, were examined. For each patient, the depth of the olfactory fossa (DOF), the width of the olfactory fossa (WOF), the angle between the lateral lamella and the cribriform plate (LLCPA), the length of the lateral lamella (LLL), the distance between the nasal floor and the ethmoid roof (NFERL), and the width of the olfactory cleft (WOC) were recorded. The Keros and Gera types were determined. NFERL was found to be significantly higher in males across all age groups. WOC was significantly higher in males only under 18 years old. Only LLCPA was found to be significantly higher on the right side in both sexes. It was determined that NFERL increased with age, while WOC increased with age until 18. Keros type III and Gera type C, which are called dangerous types, were detected in 28 and 24 cases in total, respectively. The data obtained from significant anatomical landmarks in pediatric and adult cases provide useful information about the region in preoperative planning. The analysis results of the prevalence of Keros and Gera classifications allow the identification of high-risk anatomical conditions within the ethmoid.

摘要

鼻内镜鼻窦手术中大多数潜在的主要并发症与筛骨有关。为预防并发症,有必要明确“危险筛骨”的概念。对总共271例患者的冠状面多排螺旋计算机断层扫描(MDCT)图像进行了检查,其中包括101例18岁以下患者和170例18岁以上患者。对于每例患者,记录嗅窝深度(DOF)、嗅窝宽度(WOF)、外侧板与筛板之间的夹角(LLCPA)、外侧板长度(LLL)、鼻底与筛骨顶之间的距离(NFERL)以及嗅裂宽度(WOC)。确定了Keros和Gera分型。发现所有年龄组男性的NFERL均显著更高。仅18岁以下男性的WOC显著更高。发现仅LLCPA在男女两侧均右侧显著更高。确定NFERL随年龄增加,而WOC在18岁之前随年龄增加。分别在总共28例和24例中检测到被称为危险型的Keros III型和Gera C型。从儿童和成人病例的重要解剖标志获得的数据为术前规划中的该区域提供了有用信息。Keros和Gera分类患病率的分析结果有助于识别筛骨内的高危解剖情况。

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