| Objective: According to the clinical requirement of endoscopic ethmoid sinus surgery ,a research has been performed to explore a secure and effective surgical landmarks and a safe border for the endoscopic ethmoid sinus surgery by means of the applied anatomy and nasal endoscopic ethmoidal anatomy and CT scans.The reliable anatomy data were very useful to avoiding and reducing severe complications.Methods :(1) 30 adult cadaveric heads without any lesioh were selected at random (male 23, female 7 )and split on the level between the line of superior superciliary archabove and 1.0cm high of occipital bone with Model MJ3435 band ,with brain tissue was removed , and then split axially on midline , also the nasal septum removed, after that split axially skull bone between the infraorbital foramen and central section. According to the approach of endoscopic ethmoid sinus surgery , we have measured the meridian of the anatomical structures and observed the variations of ethmoid.d)The computed tomography (CT) of ethmoid sinus were performed on 16 in-patients(male 8, female 8) with continuous 2.0mm sections through SHIMADZU SCT-4800TF machine produced by Japan , the line between infraorbital margin and superior andexternal auditory canal was adopted as axial base line, and vertical line with it as coronal plane The anatomy features and localization were studied and analysed on CT scan of ethmoid sinus.(3) Using 0 degree and 30 degree and 70 degree endoscopes ( Storze produced by Germany), anatomical dissection with the endoscopic ethmoidectomy technique has been performed in 5 cadaveric heads without any lesion and 16 in-patients with CT scan. We have studied the anatomical features and considered the planeimage of endoscopic as triaxial anatomical concept. (4) 6 adult cadaveric heads without any lesion were split on the level between the line of superior superciliary archabove and 1 .0cm high of occipital bone with Model MJ3435 band .with brain tissue was removed. The cadaveric heads were cut on axial and coronal section according to CT orientation by handsaw.We have studied the anatomical variants. Resu Its:(1) The sagittal diamete of agger nasi was 8.21 ±1.35mm; its vertical diamete was 10.63±2.13 mm; the distance from the central agger nasi to theattachment of anterior middle turbinate was 1.91 ±0.32 mm.(DThe length and width and depth of uncinate processs were16.62±3.21 mm,4.06±1.13mm and 1.34±0.41 mm,respectively. The average distance from the anterior and superior uncinate processs to the anterior attachment of middle turbinate was 0.31±0.10 mm, the vertical average distance from the posterior and inferior'uncinate processs to the attachment of inferior turbinate was 1.16±0.40 mm. (3) The maximum transversal diamete of ethmoid bulla was 8.91 ±2.82 mm ; its maximum vertical diamete was 13.92±7.08 mm ;its depth was 0.23±0.10 mm; the minimum average distance from the center of ethmoid bulla to the attachment of inferior turbinate wasl 1.96±2.31 mm .(4) The length of ethmoid roof was 27.22±6.91mm ; the width of anterior ethmoid roof and intermedium ethmoid roof and posterior ethmoid roof were 7.93±2.80 mm, 9.10±3.72 mm and 9.83±2.31 mm.respectively. (5) The average length of ethmoid roof wall: the anterior ethmoid sinus and posterior etnmoid sinus and the connection between anterior ethmoid sinus and cribriform plate were 0.72±0.20 mm,0.94±0.30 mm ,0.21±0.10 mm .respectively.(6) The sagittal diamete of suprasphenoid cells was 9.31 ±1.23 mm; its vertical diamete was 8.26±1.76 mm; the maximum transversal diamete was 7.67±2.01 mm. (7) The sagittal diamete of Ultimate ethmoid cell was 16.61 ±3.97 mm;its vertical diamete was 22.31±2.37 mm; the maximum transversal diamete was 6.91±2.01 mm (anterior); 12.54±3.32 mm (posterior) .(8) The average distance from the uncinate processs to the ethmoid bulla was 0.68±0.36 mm (superior), 1.71 ± 0.78 mm (intermedium), 2.81±0.58 mm(inferior). (9) The dis...
|
PDF Full Text Request