Cheung D K, Attia E L, Kirkpatrick D A, Marcarian B, Wright B
Department of Otolaryngology, Dalhousie University, Halifax, Nova Scotia, Canada.
J Otolaryngol. 1993 Apr;22(2):63-8.
Interest in endoscopic sinus surgery has expanded to include the sphenoid sinus. While the transnasal transethmoid approach is an established route to the sphenoid sinus, instrumentation is brought close to the lateral wall. This study organizes the lateral wall of the sphenoid sinus into three distinct areas. Fifteen fixed cadaver specimens, 15 fresh specimens and 25 axial as well as coronal CT scans are used to examine each area of the lateral wall. The orbital apex, spongy vascular tissue of the cavernous sinus and the internal carotid artery are found in tandem sequence adjacent to the lateral wall of the sphenoid sinus. A highly pneumatized sphenoid sinus may attenuate the bone over the lateral wall placing the optic nerve and carotid artery at greater risk. Anatomic variations, as examined in this study, and limitations imposed by endoscopic vision via the transnasal transethmoid approach dictates a need to understand the anatomy as well as familiarity with endoscopic surgery. Axial CT scans of the sphenoid sinus can image anatomic variations which may compromise safety of the lateral sphenoid sinus wall.
人们对鼻内镜鼻窦手术的兴趣已扩展到蝶窦。虽然经鼻经筛窦入路是进入蝶窦的既定途径，但手术器械需靠近蝶窦外侧壁。本研究将蝶窦外侧壁分为三个不同区域。使用15个固定尸体标本、15个新鲜标本以及25例轴位和冠状位CT扫描来检查外侧壁的每个区域。眶尖、海绵窦的海绵状血管组织和颈内动脉按顺序紧邻蝶窦外侧壁。高度气化的蝶窦可能会使外侧壁骨质变薄，从而使视神经和颈动脉面临更大风险。本研究中所检查的解剖变异以及经鼻经筛窦入路的内镜视野限制表明，有必要了解解剖结构并熟悉内镜手术。蝶窦的轴位CT扫描可以显示可能危及蝶窦外侧壁安全的解剖变异。
