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目的:为有关蝶窦手术提供解剖学和影像学资料。方法:采用CT技术和断层解剖方法对15例尸头和50例颅骨标本蝶窦的形态、类型、径线、毗邻等进行了观察。结果:蝶窦的前后径大于上下径,上壁和前壁较薄,下壁和后壁较厚。在蝶窦CT水平层面上可清楚显示其气化类型,前、后壁,两侧壁及中隔的位置、厚度、毗邻;在冠状层面上可显示上、下壁的厚度及上壁与垂体、颈内动脉的关系。蝶窦内可见管型视神经管隆起和管型颈内动脉隆起,其出现率分别为23.8％和21.9％。视神经管隆起仅见于发育良好的鞍前型和全鞍型蝶窦。发育良好的枕鞍型和全鞍型蝶窦的后壁较薄,最薄者仅为0.6mm。结论:蝶窦的气化程度差异较大,视神经、颈内动脉可向窦腔内突入。发育良好的枕鞍型和全鞍型蝶窦与脑干间仅隔以纸样薄骨板。经蝶窦入路手术,应控制手术操作范围,避免损伤毗邻结构。
Objective: To provide anatomical and imaging data for sphenoid sinus surgery. Methods: The morphology, type, diameter and adjacent of sphenoid sinus in 15 cases of cadaver and 50 cases of skull were observed by CT and tomography. Results: The anteroposterior diameter of the sphenoid sinus was larger than that of the upper and lower sphenoid. The upper wall and the anterior wall were thinner while the lower wall and the posterior wall were thicker. In the sphenoid sinus CT level can be clearly displayed on the type of gasification, anterior, posterior wall, both sides of the wall and septum position, thickness, adjacent to; in the coronal plane can show the thickness of the upper and lower wall and the upper wall and the pituitary , Internal carotid artery. Sphenoid sinus visible canal optic canal uplift and tubular type carotid artery uplift, the incidence rates were 23.8% and 21.9%. Optic canal bulge only found in well-developed saddle-type and full-saddle type sphenoid sinus. Well-developed pillow saddle and full saddle sphenoid posterior wall thinner, the thinnest of only 0.6mm. Conclusion: The degree of gasification of sphenoid sinus varies greatly. The optic nerve and internal carotid artery can penetrate into sinus cavity. Well-developed pillow saddle and saddle type sphenoid sinus and brainstem only separated by paper-like thin plate. Trans-transsphenoidal surgery should control the scope of the operation to avoid damage adjacent structures.