内镜经翼突及上颌窦前壁上咽旁间隙的解剖

doi:10.16098/j.issn.0529-1356.2021.06.016

解剖学报 ›› 2021, Vol. 52 ›› Issue (6): 940-944.doi: 10.16098/j.issn.0529-1356.2021.06.016

内镜经翼突及上颌窦前壁上咽旁间隙的解剖

刘全刘娟王欢张焕康孙希才* 余洪猛*

复旦大学附属眼耳鼻喉科医院耳鼻喉科，上海 200031

收稿日期:2020-04-07 修回日期:2020-06-30 出版日期:2021-12-06 发布日期:2021-12-06
通讯作者: 孙希才;余洪猛 E-mail:laryngeal@163.com
基金资助:
上海市卫生健康委员会面上项目;中国医学科学院内镜下鼻颅底肿瘤外科治疗技术创新单元;上海申康医院发展中心/新兴前沿技术联合攻关项目;上海市科学技术委员会科技创新行动计划临床医学项目

Endoscopic transpterygoid transmaxillary approach to the upper parapharyngeal space

LIU Quan LIU Juan WANG Huan ZHANG Huan-kang SUN Xi-cai* YU Hong-meng*

Department of Otolaryngology, Eye & ENT Hospital of Fudan University, Shanghai 200031,China

Received:2020-04-07 Revised:2020-06-30 Online:2021-12-06 Published:2021-12-06
Contact: SUN Xi-cai;YU Hong-men E-mail:laryngeal@163.com

摘要/Abstract

摘要：

目的研究内镜下经翼突联合上颌窦前壁上咽旁间隙的解剖，为临床上内镜经鼻处理上咽旁间隙的病变提供解剖学标志。方法在新鲜头颅标本上进行内镜经翼突联合上颌窦前壁入路暴露上咽旁间隙，测量翼内板、翼外板与茎突之间的距离；测量蝶骨棘、翼外板与颈动脉管入口之间的距离。结果共完成10例（20侧）新鲜头颅标本的内镜下上咽旁间隙的解剖，翼内板与茎突之间的距离为（28.1±3.3）mm, 翼外板后缘距离茎突的距离为（18.9±4.9）mm；翼外板与蝶骨大翼交界处距离颈内动脉管入口的距离为（14.1±3.7）mm，蝶骨棘位于颈动脉入口的前方为（6.7±1.5）mm。咽颅底筋膜、腭帆张肌和翼内肌是上咽旁间隙重要的软组织标志。结论内镜下经翼突联合上颌窦前壁入路处理上咽旁间隙病变中，可使用骨性标志翼外板根部和蝶骨棘协助定位颈动脉管外口，从而有助于咽旁段颈内动脉的定位。

关键词: 内镜, 咽旁间隙, 颈内动脉, 颅底, 解剖学, 人

Abstract:

Objective To present anatomical landmarks for endoscopic transpterygoid transmaxillary approach to the upper parapharyngeal space. Methods Anatomy of the upper parapharyngeal space using endoscopic endonasal transpterygoid transmaxillary approach was performed in cadaveric head. The distances between medial pterygoid plate, lateral pterygoid plate and styloid process were measured, respectively. The distances between lateral pterygoid plate, sphenoid spine and the entrance of carotid canal were also investigated. Results The dissection was performed in 10 fresh cadaver heads (20 sides). The distance between medial pterygoid plate, lateral pterygoid plate and styloid process were (28.1±3.3)mm and (18.9±4.9)mm respectively. The distances between lateral pterygoid plate, sphenoid spine and the entrance of carotid canal were (14.1±3.7)mm and (6.7±1.5)mm respectively. Pharyngobasilar fascia，medial pterygoid muscle and tensor veli palatini muscle were key landmarks of the upper parapharyngeal space. Conclusion The bone landmarks of lateral pterygoid plate and sphenoid spine are effective in identification of the entrance of carotid canal, which is helpful to locate the parapharyngeal segment of internal carotid artery.

Key words: Endoscopy, Parapharyngeal space, Internal carotid artery, Skull base, Anatomy, Human

中图分类号:

R765.9

刘全刘娟王欢张焕康孙希才余洪猛 . 内镜经翼突及上颌窦前壁上咽旁间隙的解剖[J]. 解剖学报, 2021, 52(6): 940-944.

LIU Quan LIU Juan WANG Huan ZHANG Huan-kang SUN Xi-cai YU Hong-meng. Endoscopic transpterygoid transmaxillary approach to the upper parapharyngeal space[J]. Acta Anatomica Sinica, 2021, 52(6): 940-944.

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内镜经翼突及上颌窦前壁上咽旁间隙的解剖

Endoscopic transpterygoid transmaxillary approach to the upper parapharyngeal space

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