中鼻甲连续冠状断面解剖及3D数字重建

栾宁; 安凤杨; 孙健斌; 王玉辉; 李丽娟; 骆岩林; 李涛; 朱丽

doi:10.16098/j.issn.0529-1356.2020.05.001

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解剖学报 ›› 2020, Vol. 51 ›› Issue (5) : 637-643. DOI: 10.16098/j.issn.0529-1356.2020.05.001

解剖学与耳鼻喉科学

中鼻甲连续冠状断面解剖及3D数字重建

栾宁¹ 安凤杨¹ 孙健斌¹王玉辉¹ 李丽娟¹ 骆岩林² 李涛^1*朱丽^1*

作者信息 +

Continuous sectional anatomy of the middle turbinate and 3D digital reconstruction#br#

LUAN Ning¹ AN Feng-yang¹ SUN Jian-bin1 WANG Yu-hui¹LI Li-juan¹ LUO Yan-lin² LI Tao^1* ZHU Li^1*

Author information +

文章历史 +

摘要

目的探讨中鼻甲连续冠状位断面解剖特点，结合薄层CT扫描及3D数字重建，为自后向前的鼻窦手术提供结构解剖学基础。方法 4具（8侧）成人尸头标本，行鼻窦螺旋CT扫描获取图像后，行连续冠状位断面解剖，并对相应层面的CT图像进行结构标注，观察中鼻甲3部分的形态学特点及与CT影像的对应关系；通过薄层鼻窦CT进行3D立体数字重建中鼻甲。结果连续冠状位断面解剖自后向前观察中鼻甲各部分形态特点为，中鼻甲水平部内侧游离端为球状并以板状结构附着于鼻腔外侧壁；板状结构向前分为前后骨板，前为筛泡基板，后为中鼻甲基板，斜行向前向上附着于脑板；在筛泡基板与中鼻甲基板之间为前组筛窦；中鼻甲垂直部自中鼻甲水平部以矢状位向上呈扇形附着于额鼻嵴及脑板；以冠状位断面解剖中鼻甲3部分典型形态标注鼻窦CT图像；完成了中鼻甲形态数字三维重建。结论从冠状位断面形态观察，可以归纳出自后至前中鼻甲形态变化规律，为自后向前的手术径路提供解剖学依据。

Abstract

Objective To study the characteristics of continuous coronal sectional anatomy of middle turbinate combined with thin-layer CT scanning and 3D digital reconstruction, so as to provide the structural anatomical basis for the operation of nasal sinus from back to front. Methods Four adult cadaver heads (8 sides) were scanned by spiral CT of the paranasal sinuses, and then dissected in continuous coronal section. The corresponding CT images were labeled to observe the morphological characteristics of the 3 parts of the middle turbinate and the corresponding relationship with CT images. The middle turbinate was reconstructed by 3D threedimensional digital reconstruction with thin slice CT of the paranasal sinuses.

Results The morphological characteristics of the middle turbinate were as follows: the free end of the horizontal part of the middle turbinate was spherical and attached to the lateral wall of the nasal cavity with plate-like structure; The plate-like structure was divided into anterior and posterior bone plates, the former was ethmoidal base plate, the latter was middle nasal methyl plate, and attached to the brain plate obliquely forward and upward; Between the ethmoidal base plate and the middle turbinate base was the anterior ethmoidal sinus; The vertical part of the middle turbinate was attached to the frontal nasal ridge and brain plate in a fan-shaped upward sagittal position from the horizontal part of the middle turbinate; The CT images of the three typical parts of the middle turbinate in the sectional anatomy of the coronal position were marked; The three-dimensional reconstruction of the middle turbinate is completed. Conclusion The morphological changes of the posterior to anterior middle turbinate can be concluded from the observation of the sectional morphology of the coronal position, which provides the anatomical basis for the operation route from the posterior to the anterior.

导出引用

栾宁安凤杨孙健斌王玉辉李丽娟骆岩林李涛朱丽. 中鼻甲连续冠状断面解剖及3D数字重建[J]. 解剖学报. 2020, 51(5): 637-643 https://doi.org/10.16098/j.issn.0529-1356.2020.05.001

LUAN Ning AN Feng-yang SUN Jian-bin WANG Yu-hui LI Li-juan LUO Yan-lin LI Tao ZHU Li. Continuous sectional anatomy of the middle turbinate and 3D digital reconstruction#br#[J]. Acta Anatomica Sinica. 2020, 51(5): 637-643 https://doi.org/10.16098/j.issn.0529-1356.2020.05.001

中图分类号： R323.1

参考文献

［1］ Cui YH, Liu Zh. Pay attention to the prevention and treatment of serious complications of endoscopic sinus surgery ［J］. Journal of Clinical Otorhinolarynglolgy Head and Neck Surgery, 2011, 25(8):337-338. (in Chinese)
崔永华, 刘争. 重视鼻内镜手术严重并发症的防治［J］. 临床耳鼻咽喉头颈外科杂志, 2011, 25(8):337-338.
［2］ May M, Levine HL, Mester SJ, et al. Complications of endoscopic sinus surgery: analysis of 2108 patients —incidence and prevention［J］. Laryngoscope,1994,104(9): 1080-1083.
［3］ Sunkaraneni VS, Nair SB. Complications of endoscopic sinus surgery ［J］. Otorhinolaryngologist, 2010, 3(2):48-51.
［4］ Lee JY, Won Lee S. Preventing lateral synechia formation after endoscopic sinus surgery with a silastic sheet［J］. Arch Otolaryngol Head Neck Surg, 2007, 133(8):77-779.
［5］ Wu HB，Yuan HSh，Zhu L. Surgical value of thin slice reconstruction of CT on the middle turbinate structure［J］.Journal of Clinical Radiology，2013,32(3):20-24. (in Chinese)
邬海博, 袁慧书, 朱丽. CT薄层重建对于中鼻甲结构的外科解剖价值［J］. 临床放射学杂志，2013,32(3):20-24.
［6］ Li T, Zhu L，Liu JX, et al. Application of optical image-guided system in complex endoscopic sinus surgery［J］.Chinese Journal of Minimally Invasive Surgery，2018，18（1）：50-54. (in Chinese)
李涛，朱丽，刘俊秀，等.光学影像导航系统在疑难鼻内镜手术系统中的应用［J］.中国微创外科杂志，2018,18（1）：50-54.
［7］ Getz AE, Hwang PH. Basal lamella relaxing incision improves endoscopic middle meatal access ［J］. Int Forum Allergy Rhinol, 2013, 3(3):231-235.
［8］ Rosano G, Taschieri S, Gaudy JF, et al. Maxillary sinus vascular anatomy and its relation to sinus lift surgery ［J］. Clin Oral Implants Res, 2010, 22(7):711-715.
［9］ Lin LB, Xiong ChM, Han M, et al. Sectional anatomy of pancreas on the coronal plane and its correlation with MSCT images ［J］. Journal of Shandong University (Health Sciences), 2012, 50(9):86-90. (in Chinese)
林令博, 熊春梅, 韩梅,等. 胰腺冠状断层解剖与多层螺旋CT冠状位图像研究［J］.山东大学学报(医学版),2012, 50(9):86-90.
［10］ Duan JR, Wei JP, Li MZh，et al. Comparative study between sectional anatomy and CT image of temporal bone including posterior tympanum ［J］. Chinese Journal of Clinical Anatomy，2006, 24(4):355-358. (in Chinese)
段菊如, 魏江平, 李明智,等. 后鼓室颞骨切片与CT对照研究［J］. 中国临床解剖学杂志, 2006, 24(4):355-358.
［11］ Netto B, Piltcher OB, Meotti CD, et al. Computed tomography imaging study of the superior attachment of the uncinate process ［J］. Rhinology, 2015, 53(2): 187-191.
［12］ Fu ShQ, Fan XY, Miao YY, et al. Three-dimensional reconstruction of the mandibular canal and its clinical significance ［J］. Chinese Journal of Clinical Anatomy，2011,29(4) 375-381. (in Chinese)
付升旗, 范锡印, 苗莹莹,等. 下颌管的三维重建及临床意义［J］. 中国临床解剖学杂志, 2011,29(4) 375-381.
［13］ He ZX, Zhu L, Li MJ, et al.Rapid and high-quality 3D fusion of heterogeneous CT and MRI data for the human brain ［J］. Science China Information Sciences, 2019, 62(10):204101:1-3.
［14］ Xu M, Jiang K, Wang XD, et al. Clinical anatomy of the vidian nerve ［J］. Acta Anatomica Sinica, 2015, 46(2): 227-231. (in Chinese)
徐明,江凯,王新东,等.翼管神经的应用解剖学［J］.解剖学报,2015,46(2):227-231.