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Object: The mechanism and method of the neurectomy were explored in the treatment of e allergic rhinitis.The basic on anatomy and theory was provided for treating allergic rhinitis by surgical way. Methods:A team of Rabbits were made sensitization three days after the sphenoidpalatine nerve was cut or sympathetic nerve was cut.

目的:本研究旨在了解蝶腭神经切断治疗变应性鼻炎的机理和方法,了解感觉神经及其产生的神经肽在变应性鼻炎发病中的作用,了解鼻后外侧神经、筛前神经进入下鼻甲的确切位置,为切断相关神经治疗变应性鼻炎提供理论基础。

The available operation range in clivus and anterior cranial base by transsphenoidal opproach was also observed during the operation under the help of neuronavigational pointer. Forty-one patients underwent sublabial, transseptal, transsphenoidal approach to the pituitary region guided by Surgical Microscope Navigation was studied. The piriform aperture was 27. 2mm±3. 1 , the origin of inferior nasal concha 30mm±4. 1, the origin of middle nasal concha 27. 9mm±4. 3. These data are important for transsphenoidal approach, because the piriform aperture and the origin of both inferior and middle nasal conchas restricted the opening width of the Hardy specula. If any distance of these bony structures was much less than the mean one, may cause inadequate opening of the specula blade and resulting dissatisfied operative field. Microadenomas or cystic tumors perhaps can be operated even in a narrow exposure, but large or giant solid adenomas may need a proper evaluation including changing the operative approach or performing a bilateral submucous inferior conchotomy or posterior ethmoidectomy firstly.

手术中还利用CT导航系统观察棒研究了经口—鼻蝶窦入路在斜坡区和前颅底能够达到的实际有效操作范围,为扩大经蝶窦入路手术在斜坡区和前颅底的应用奠定基础,在国内外尚未见同类报道。41例垂体瘤患者梨状孔平均宽度27.2mm±3.1,下鼻甲根部附着处间距30mm±4.1,中鼻甲根部附着处间距27.9mm±4.3,这是经口—鼻蝶窦入路手术中,对Hardy双瓣鼻窥器张开限制的主要骨性结构,若患者这些径线值明显小于平均值,则可能因为鼻窥器打开不充分而影响手术暴露,当然对于垂体微腺瘤和以囊变为主的垂体瘤可能影响不大,但对于大和巨大垂体瘤必须要有充分的准备,包括评估是否改用其他入路,或先行鼻甲切除再行经蝶手术。

Different surgical approaches to the sphenoid sinus should be chosen based on the target of the operation; the arcus choanalis, the middle and superior turbinates are invariable orientative landmarks for sphenoid sinus.

根据手术的目的可以选择不同的方法开放蝶窦,中鼻甲、上鼻甲以及后鼻孔弓都是定位蝶窦的恒定标志。

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