Scarbrough F E, Ghali G E, Smith B R
Department of Oral & Maxillofacial Surgery, Medical College of Georgia, USA.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1997 Nov;84(5):465-8. doi: 10.1016/s1079-2104(97)90258-4.
External reference points, particularly Kirschner pins (K-wire), placed in the region of the nasion have been shown to improve the accuracy of maxillary vertical repositioning. Although no complications associated with this technique have been reported, there is a potential for injury to the anterior cranial fossa or frontal sinus. The purpose of this study was to measure the shortest distance from the nasion to the anterior cranial fossa and from the nasion to the frontal sinus. These measurements were used to establish anatomic guidelines governing safe placement of external reference point pins.
Twenty-seven cadaver heads were sectioned in the midsagittal plane for gross study. Using a Boley gauge, two specific measures were obtained: (1) distance from deepest depression of nasion to the most anterior and inferior projection of the anterior cranial fossa, and (2) distance from nasion to the most inferior aspect of the frontal sinus. All measurements were made in the midsagittal plane.
The average distance from nasion to anterior cranial fossa was 16.9 mm (range 13.0 to 20.0 mm) and the smallest distance, 13.0 mm, was seen in two specimens. The average distance from nasion to the frontal sinus was 6.2 mm (range 2.0 to 10.0 mm) and the smallest distance, 2.0 mm, was seen in three specimens.
Based on our findings, we recommend the following: (1) place pin to a depth of no more than 8 mm into bone, (2) place pin 5 to 10 mm inferior to soft tissue nasion, and (3) place pin in an anterosuperior to posteroinferior direction (i.e., roughly perpendicular to the nasal dorsum). When these anatomic guidelines are followed, one would expect minimal morbidity associated with the placement of ERP pins.
已证明置于鼻根区域的外部参考点，尤其是克氏针（K 线），可提高上颌垂直复位的准确性。尽管尚未有与该技术相关的并发症报道，但仍存在损伤前颅窝或额窦的可能性。本研究的目的是测量从鼻根到前颅窝以及从鼻根到额窦的最短距离。这些测量结果用于制定指导外部参考点针安全放置的解剖学指南。
对 27 个尸体头部进行矢状面剖切以进行大体研究。使用博利测径器获得两项具体测量值：（1）从鼻根最深凹陷处到前颅窝最前下突出处的距离，以及（2）从鼻根到额窦最下方面的距离。所有测量均在矢状面进行。
从鼻根到前颅窝的平均距离为 16.9 毫米（范围为 13.0 至 20.0 毫米），在两个标本中观察到最小距离为 13.0 毫米。从鼻根到额窦的平均距离为 6.2 毫米（范围为 2.0 至 10.0 毫米），在三个标本中观察到最小距离为 2.0 毫米。
基于我们的研究结果，我们建议如下：（1）将针插入骨内的深度不超过 8 毫米，（2）将针置于鼻根软组织下方 5 至 10 毫米处，（3）将针从前上方向后下方放置（即大致垂直于鼻背）。遵循这些解剖学指南时，预计与放置 ERP 针相关的发病率会降至最低。
