Intranasal anatomy of the nasolacrimal sac in endoscopic dacryocystorhinostomy
Intranasal anatomy of the nasolacrimal sac in endoscopic dacryocystorhinostomy
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DOI：
10.1067/mhn.2000.105416
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发表时间：
2000-09-01
影响因子：
3.4
通讯作者：
Van Hasselt, A
中科院分区：
文献类型：
--
作者：
Wormald, PJ;Kew, J;Van Hasselt, A
鼻内表面解剖是鼻内镜下泪囊鼻腔吻合术的基础。在目前的文献中，泪囊被描述为位于中鼻甲前端的前方，其中0%至20%的泪囊位于中鼻甲附着点上方的外侧鼻壁（中鼻甲的腋窝）上。本研究的目的是使用CT泪囊造影（DCGs）和CT扫描来建立泪囊与鼻侧壁的关系。测量了47个泪囊与总泪小管的关系，测量了76个泪囊与中鼻甲插入的关系。从鼻甲骨长轴测量，鼻甲骨在中鼻甲止点上方的平均高度为8.8mm（SD = 0.2，95% CI = 1.3），低于4.1 mm（SD = 2.3，95%CI = 1.1），CT动态心电图上泪小管上泪囊的平均测量值为5.3mm（SD = 1.7，95% CI = 0.56），而总泪小管下方的平均测量值为7.7 mm（SD = 2，95% CI = 1.3）（n = 47例CT DCG），本研究的结果表明，鼻囊的主要部分位于中鼻甲前端插入点上方，此外，囊的重要部分位于总泪小管的进入点上方。这些发现的知识可以确保在泪囊鼻腔吻合术中通过去除足够的中鼻甲前附着点上方的骨和粘膜来充分暴露泪囊。
Intranasal surface anatomy is fundamental to the technique of endoscopic dacryocystorhinostomy. In the current literature the lacrimal sac is described as being situated anterior to the anterior end of the middle turbinate with between 0% and 20% of the sac above the insertion of the middle turbinate on the lateral nasal wall (the axilla of the middle turbinate). The aim of this study was to use CT dacryocystograms (DCGs) and CT scans to establish the relationship of the lacrimal sac to the lateral nasal wall. Forty-seven individual lacrimal sacs were measured in relation to the common canaliculus, and 76 were measured in relation to the insertion of the middle turbinate. Measurements taken from the long axis of the sac showed the mean height of the sac above the middle turbinate insertion was 8.8 mm (SD = 0.2, 95% CI = 1.3) and below it was 4.1 mm (SD = 2.3, 95% CI = 1.1), The average measurement of the sac above the common canaliculus on CT DCGs was 5.3 mm (SD = 1.7, 95% CI = 0.56), whereas the average measurement below the common canaliculus was 7.7 mm (SD = 2, 95% CI = 1.3) (n = 47 CT DCGs), The findings in this study show that a major portion of the sac is located above the insertion of the anterior end of the middle turbinate and, in addition, that a significant part of the sac lies above the entry point of the common canaliculus. Knowledge of these findings con ensure that the sac is adequately exposed during dacryocystorhinostomy by removal of sufficient bone and mucosa above the anterior insertion of the middle turbinate.