鼻内镜下鼻腔泪囊造口术应用解剖数据研究.docVIP

鼻内镜下鼻腔泪囊造口术应用解剖数据研究 　　[摘要] 目的 ??用解剖学方法测量鼻腔泪囊解剖数据，为鼻科医生内镜手术提供数据和指导，以提高鼻腔泪囊造口成功率，减少并发症。方法 以2012年1月―2017年1月南京医科大学解剖教研室28个无病损完整尸头（56侧）为研究对象。观察鼻泪管解剖结构及中鼻甲腋、总泪小管和泪囊的解剖关系，鼻内镜下不锈钢游标卡尺测量鼻泪管长度、中鼻甲腋与泪囊顶、中鼻甲腋与泪囊底、总泪小管入口与泪囊底间距离等指标。结果 尸头标本鼻泪管长度（15.87±1.93）mm，中鼻甲腋至泪囊顶距离（7.81±1.63）mm，中鼻甲腋至泪囊底距离（7.62±1.88）mm，总泪小管入口至泪囊底距离（11.20±1.69）mm。结论 鼻内镜下鼻腔泪囊造口术以中鼻甲腋为主要标志，有利于准确定位泪囊管。但泪囊与鼻泪管解剖变异较大，建议术前影像学观察泪囊与中鼻甲腋的解剖关系，选择鼻丘隆突下缘处为鼻泪管上口位，下鼻道前端顶壁、侧壁处为鼻泪管上口位。 　　[关键词] 鼻内窥镜；鼻腔泪囊造口术；应用解剖学；解剖数据 　　[中图分类号] R777 [文献标识码] A [文章编号] 1674-0742（2018）01（c）-0071-03 　　[Abstract] Objective The application of anatomical method to measure nasal lacrimal sac anatomic data and to provide the data and guidance for the endoscopic operation of rhinologists to improve the success rate of nasal lacrimal sac stoma and to reduce the complications. Methods From January 2012 to January 2017， 28 intact cadaveric heads （56 sides） of Department of Anatomy， Nanjing Medical University were studied. The anatomic structure of the nasolacrimal duct and the anatomy of the middle turbinate axillary and total lacrimal duct and lacrimal sac were observed. The length of the nasolacrimal duct was measured by endoscopic stainless steel vernier caliper. The middle turbinate axillary and dacryocystorhinostomy， Lacrimal duct entrance and the distance between the dacryocystis and other indicators were observed. Results Cadaveric head specimens of nasolacrimal duct length （15.87±1.93）mm， middle turbinate and lacrimal sac top distance（7.81±1.63）mm， middle turbinate and lacrimal sac bottom distance （7.62±1.88）mm， the total entrance to the lacrimal canaliculus bottom distance（11.20±1.69）mm. Conclusion Nasal endoscopic dacryocystorhinostomy is the main sign of the middle turbinate， which is helpful for the accurate localization of the lacrimal duct. But dacryocystitis and nasolacrimal duct anatomical varied a lot， it was recommended preoperative imaging anatomy observation of lacrimal sac and middle turbinate， nasal inferior edge for long hill with