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Preservation of ethmoid bulla, opening the frontal sinus mostly keep away from anterior ethmoid artery and cribriform roof, this bring down the risk of injuries to anterior ethmoid artery and cribriform roof.
保留筛泡,在筛泡前开放额窦多数情况下可以避开筛前动脉以及筛顶,降低筛前动脉出血和损伤筛顶的风险。
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Objective To study the scanning technique of HRCT for demonstrating the anatomical structures of the frontal sinus and its drainage channels, including ostium of frontal sinus, nasofrontal duct, ethmoid infundibulum, middle nasal meatus, etc.
目的 探讨高分辨力CT扫描对额窦引流通道(鼻额管、额窦窦口、筛漏斗、中鼻道等)解剖结构的显示及其扫描技术。
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The ostium of frontal sinus Positions should be divided into two type by the interaction of basal lamella of bulla and cribriform roof. TypeⅠ: The ostium of frontal sinus is located in lateral sinus, flows through superiorsemilunar hiatus to middle nasal meatus. It is about 20%. TypeⅡ: The ostium of frontal sinus is located in ethmoid infundibulum, frontal recess and its cell, flows through interior semilunar hiatus to middle nasal meatus. It is about 80%. Among them there are about 62.5% in ethmoid infundibulum, about 37.5% in frontal recess.
额窦鼻口的位置可根据筛泡基板与筛顶连接的情况划分为两种类型:Ⅰ型额窦的鼻口开口于侧窦,经上半月裂流入中鼻道,约占20%;Ⅱ型开口于筛漏斗、额隐窝及其气房,经下半月裂流入中鼻道,约占80%,其中开口于筛漏斗约为62.5%;开口位于额隐窝约为37.5%。
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Results The total 100 frontal sinuses were all revealed. Of 100 ostia, nasofrontal ducts, ethmoid infundibula, and middle nasal meatuses, 4 didn't show up and 96 could be viewed with air channel and bone channel structures well demonstrated in 70, and the remaining 26 still showed their bone channel structures though their air channel structures were vanished.Conclusion The structures of the ostium of frontal sinus, nasofrontal duct, ethmoid infundibulum, middle nasal meatus, etc.
结果 50例被检查者的50个额窦全部显示;100个窦口、鼻额管、筛漏斗及中鼻道结构,4个未显示,96个被显示,其中70个窦口、鼻额管、筛漏斗及中鼻道的气道结构和骨结构均清晰可见,26个窦口、鼻额管、筛漏斗及中鼻道的气道结构消失但骨结构仍可见。
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Grind down the frontal sinus from superciliary archand show nasal ostium of frontal sinus, basal lamella of bulla and its front, cribriform roof.
重点观察筛漏斗、额隐窝及其气房、额窦窦口及鼻腔开口、筛泡基板与筛顶的连接情况。
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Results The tristar of groove was consisted of beak of the ethmoidal bulla and its prolonging process, apex of the uncinate process and anterior peak of the middle turbinate, at the region of frontal recess. The structures called meatal groove, uncinate groove and bullar groove were observed around the ethmoidal bulla and the tristar of groove located at their origination. Under endoscopic view these structures looked like a triangular clefts, so it was named.
结果 星状裂是由筛泡的顶端及其向上伸出的角、钩突的顶端、中鼻甲的前顶端在额隐窝区域汇合形成的一个星状裂隙,上述结构围绕筛泡形成鼻道沟、钩突沟、筛泡沟,星状裂为三条沟的起始部。
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Methods Nasofrontal duct was extended and the bottom of frontal sinus was opened under nasal endoscope.
目的 观察筛窦切除术+额窦开放术与单纯筛窦切除术治疗慢性额窦炎的疗效方法在内窥镜下扩鼻额管,开放额窦底。
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Results (1) Cells in frontal recess: The existence of terminal cells was 45.5% in frontal sinusitis group and 23.7% in, control; anterior ethmoid cell 31.8% and 15.3%; agger nasi cells 28.8% and 13.5%.(2) Cells in frontal sinus: for perifrontal cells there were 42.4% and 22%, respectively; superaorbital cells 33.3% and 25.4%; intersinus septal cells 27.3% and 20%.
①额隐窝内出现的相关气房(无额窦炎组出现率/额窦炎组出现率):终末气房(23.7%/45.5%),前筛气房(15.3%/31.8%),鼻丘气房(13.5%/28.8%);②额窦内出现的相关气房:额气房(22%/42.4%),眶上气房(25.4%/33.3%),额窦中隔气房(20%/27.3%)。
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Results The penumatization rate of total or inferior part of middle turbinate correlated positively to the inflammation of anterior ethmoid and maxillary sinuses. Compared with patients with normal frontal sinuses, the vertical diameters of agger nasi cells of patients with frontal sinusitis were larger(11.70±5.50 mm and 8.54±3.67 mm respectivevy, p<0.01).Compared with patients with normal maxillary sinuses, the Haller's cells of patients with maxillary sinusitis were larger (77.8% and 33.3%,P<0.05)and the amount of inflammatory Haller's cells of the latter was more abundant than that of the former(91.6±17.8 mm2 and 41.6±12.6 mm2, respectively, P<0.05). The deviation of uncinate process was one of the factors of maxillary sinusitis .The sizes of ethmoid bullae increased with the soft tissue thickening in anterior ethmoid sinus, the large ethmoid bulla may cause anterior ehmoid sinusitis.
结果 全中甲或中甲下部气化的发生率随前筛、上颌窦内软组织影增厚而升高;有额窦炎组病人的鼻丘气房最大纵向垂径明显大于无额窦炎组(分别为11.7±5.5 mm和8.5±3.7 mm,P<0.01);Haller气房在上颌窦炎组和非上颌窦炎组的发生率无显著差异,但前组发生炎症的Haller气房明显多于后组(分别为77.8%和33.3%,P<0.05),且前组Haller气房的冠状位截面积明显大于后组(分别为91.6±17.8 mm2和41.6±12.6 mm2,P<0.05);钩突角度随上颌窦内软组织增厚而减小;筛泡冠状位截面积随前筛窦内软组织增厚而增大(P<0.01)。
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The situation of frontal sinus ostium and frontal recess was as follows:56 sides obstructed by swollen mucosa,polypoid mucosa or polyps,no cell obstruction at frontal sinus orifice;121 cases constricted by over development of agger nasi cells,ethmoid bulla or terminal cell at frontal recess;osteal stenosis at frontal sinus orifice in 5 sides.
额窦口和额隐窝情况分3种:①局部没有气房阻塞,仅为肿胀息肉样变黏膜或息肉阻塞者56侧(30.7%);②额隐窝被发育过度的鼻丘气房、前筛气房或终末气房挤压导致引流通道狭窄者121侧(66.5%);③额窦口骨性狭窄者5侧(2.8%)。
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maxillary:上颌骨
1.上颌骨(maxillary)上颌骨是面部结构的锁钥. 除下颌骨外,它与面部许多骨,如额、鼻、泪、筛、犁、腭、颧等骨直接连接. 因此,下颌发育对面部的发育关系甚大.
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sinusitis:鼻窦炎
鼻窦炎(sinusitis)是较为常见的疾病以上颌窦炎的发病率最高其次是筛窦炎额窦炎和蝶窦炎如所有鼻窦受累则称为全鼻窦炎(pansinusitis)本病多由鼻源性细菌感染引起偶为牙源性或血源性细菌感染除病原菌的类型和毒力外全身抵抗力降低
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chronic sinusitis:慢性鼻窦炎
慢性鼻窦炎(chronic sinusitis) 大多由于急性鼻窦炎反复发作所致,营养不良、身体抵抗力差、变态反应体质、纤毛无力综合征、及增殖腺肥大亦为致病原因. 慢性上领窦炎及筛窦炎发病率较高,额窦及蝶窦发病率较低. 慢性鼻窦炎可为慢性支气管炎、支气管扩张症或支气管哮喘的病灶,
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paranasal sinuses:鼻旁窦
鼻旁窦(paranasal sinuses)鼻腔周围的颅骨,有些含气的空腔,与鼻腔相通,称鼻旁窦. 共四对,包括额窦、上颌窦、筛窦和碟窦,它们皆与鼻腔相通,额窦位于额骨内,开口于中鼻道;上颌窦最大,位于鼻腔两侧的上颌骨内,开口于中鼻道,由于窦口高于窦底部,
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parasphenoid:副蝶骨
2.骨化程度不高,骨块数目也很少,软骨性硬骨有侧枕骨,眶蝶骨(或单块筛蝶骨)和 前耳骨(protic)各一对,而膜性硬骨也只有颅骨背面的鼻骨,额骨,顶骨(或愈合成额顶骨 frontoparietal)各一对.颅侧有一块鳞骨(squamosal),颅底由单块副蝶骨 (parasphenoid)和一对犁骨构成.鱼
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pyocele:脓囊肿
或因黏膜分泌物中的蛋白含量过多而引起的一系列生化和免疫反应所致. 本病多发生于筛窦和额窦,蝶窦和上颌窦少见,一般为单侧发病. 2.脓囊肿(pyocele)由于继发化脓性感染而形成,易引起窦壁骨质的吸收破坏,并可向颅内扩展并发颅内感染.
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sphenoidal sinus:蝶窦
检查可见中鼻甲肿胀、肥大或鼻息肉样变,以前端为明显,中鼻道前上部有脓液,可认为来自额窦;"蝶窦(sphenoidal sinus)位于蝶骨体内,左右各一,均各通过其前壁的孔开口于蝶筛隐窝.