Meyers R M, Valvassori G
Department of Otolaryngology-Head and Neck Surgery, University of Illinois at Chicago, 60612, USA.
Laryngoscope. 1998 Mar;108(3):422-5. doi: 10.1097/00005537-199803000-00020.
Four hundred computed tomography (CT) scans of patients undergoing endoscopic sinus surgery were studied with particular attention to anatomic variations. Six specific variations were identified that may predispose the surgeon to inadvertent penetration of the orbit or anterior cranial cavity. These anatomic variants are: 1. lamina papyracea lies medial to the maxillary sinus ostium; 2. maxillary sinus hypoplasia; 3. fovea ethmoidalis abnormalities, such as low or sloping fovea and encephaloceles; 4. lamina papyracea dehiscence resulting in herniation of orbital content into the ethmoids; 5. sphenoid sinus wall variations such as septa attached to the carotid covering, and penetration of the sphenoid by the internal carotid artery or optic nerve; 6. sphenoethmoid cells (Onodi cells), the most posterior ethmoid cells pneumatizing lateral and superior to the sphenoid and intimately associated with the optic nerve.
对400例接受鼻内镜鼻窦手术患者的计算机断层扫描（CT）进行了研究，特别关注解剖变异情况。确定了六种特定变异，这些变异可能使外科医生在手术时容易不慎穿透眼眶或前颅腔。这些解剖变异包括：1. 纸样板位于上颌窦口内侧；2. 上颌窦发育不全；3. 筛泡异常，如低位或倾斜的筛泡以及脑膨出；4. 纸样板裂开导致眶内容物疝入筛窦；5. 蝶窦壁变异，如隔附于颈动脉覆盖物、颈内动脉或视神经穿透蝶窦；6. 蝶筛气房（Onodi气房），即最靠后的筛窦气房，向蝶窦外侧和上方气化并与视神经密切相关。
