目标:外部参考点,特别是克氏针(K线),放置在鼻部区域已被证明可以提高上颌垂直重新定位的准确性。尽管没有报道与该技术相关的并发症,前颅窝或额窦有可能受伤。这项研究的目的是测量从鼻到前颅窝以及从鼻到额窦的最短距离。这些测量用于建立控制外部参考点销的安全放置的解剖指南。
方法:在中矢状面切开27具尸体头部,进行大体研究。用博利压力计,获得了两个具体的措施:(1)从nasion的最深凹陷到前颅窝的最前面和最下面的投影的距离,和(2)从鼻孔到额窦最下方的距离。所有测量均在中矢面进行。
结果:从鼻骨到前颅窝的平均距离为16.9毫米(范围为13.0至20.0毫米),最小的距离,13.0mm,在两个标本中看到。鼻窦到额窦的平均距离为6.2mm(范围为2.0到10.0mm),距离最小,2.0mm,在三个标本中看到。
结论:根据我们的发现,我们建议如下:(1)将针脚放置到骨头的深度不超过8毫米,(2)将针脚5至10毫米置于软组织鼻下,和(3)将销放置在前上至后下方向(即,大致垂直于鼻背)。当遵循这些解剖指南时,人们期望与ERP引脚的放置相关的发病率最低。
OBJECTIVE: External reference points, particularly Kirschner pins (K-wire), placed in the region of the nasion have been shown to improve the accuracy of maxillary vertical repositioning. Although no complications associated with this technique have been reported, there is a potential for injury to the anterior cranial fossa or frontal sinus. The purpose of this study was to measure the shortest distance from the nasion to the anterior cranial fossa and from the nasion to the frontal sinus. These measurements were used to establish anatomic
guidelines governing safe placement of external reference point pins.
METHODS: Twenty-seven cadaver heads were sectioned in the midsagittal plane for gross study. Using a Boley gauge, two specific measures were obtained: (1) distance from deepest depression of nasion to the most anterior and inferior projection of the anterior cranial fossa, and (2) distance from nasion to the most inferior aspect of the frontal sinus. All measurements were made in the midsagittal plane.
RESULTS: The average distance from nasion to anterior cranial fossa was 16.9 mm (range 13.0 to 20.0 mm) and the smallest distance, 13.0 mm, was seen in two specimens. The average distance from nasion to the frontal sinus was 6.2 mm (range 2.0 to 10.0 mm) and the smallest distance, 2.0 mm, was seen in three specimens.
CONCLUSIONS: Based on our findings, we recommend the following: (1) place pin to a depth of no more than 8 mm into bone, (2) place pin 5 to 10 mm inferior to soft tissue nasion, and (3) place pin in an anterosuperior to posteroinferior direction (i.e., roughly perpendicular to the nasal dorsum). When these anatomic
guidelines are followed, one would expect minimal morbidity associated with the placement of ERP pins.