关键词：蝶窦；影像解剖学；CT扫描
【摘要】目的：为开展经鼻蝶窦鞍区手术及功能性鼻窦内窥镜手术提供蝶窦的影象解剖学基础。方法：取50具成人头颅标本，行冠状位、矢状位及水平位薄层CT扫描。观测蝶窦气化发育的情况，根据蝶窦向蝶骨体、蝶骨小翼及鞍背气的情况，根据蝶窦向蝶骨体、蝶骨小翼及鞍背气化的程度进行分型分度。结果：100侧蝶窦中属甲介型为4%，鞍前型为18%，半鞍型为8%，全鞍型为14%，鞍枕型为46%；另外测得蝶窦的最大左右长的平均值：左18.5mm，右17.6mm；最大前后径的平均值：左22.2mm，右20.8mm；最大上下径的平均值：左21mm，右20.4mm。从正中线至蝶窦外侧壁的距离左平均14.8mm，右15.2mm。结论：冠状位以及水平位CT扫描能清晰显示两侧蝶窦腔气化发育的情况，气化程度不同的蝶窦在选择手术进路时有着极其重要的指导意义。
Imaging anatomy study of the sphenoid sinus
Liao Jianchun,Chen Juxiang,Wang Haiqing,et al.
Department of Otolaryngology,Changzheng Hospital of the Second Military Medical University,Shanghai 200003
Objective :To provide image anatomy basis of the sphenoid sinus for the transnasal sphenoid approach and endoscopic sinus surgery.Methods:The pneumatization of sphenoid sinus of 50 cadaver heads was studied through thinner CT scanning with coronal,sagittal and axial position.The sphenoid sinus was classified according to degree of pneumatization towards sphenoid bone,small wing of sphenoid bone and epippium.Results:The sphenoid sinus could be divided into five types such as concha type,pre-sella type,semi-sella type,sella type and sella-occipital type.The corresponding incident of each type was 4%,18%,18%,14% and 40% separately.The maximum transversal diameter of the sphenoid sinuswas 18.5 mm for left and 17.6 mm for right.The maximum sagittal diameter was 22.2 mm for left and 20.8 mm for right.The maximum vertical diameter was 21.0 mm for left and 20.4 mm for right.The distance between the lateral wall of sphenoid sinus and the middle line of body was 14.8 mm for left and 15.2 mm for right.Conclusion:Thinner CT sacnning with coronal and sagittal position can show the pneumatization of both side sphenoid sinus clearly.The different peumatization of sphenoid sirus shluld be taken into account when choose the operation approach.
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