Краніометричне дослідження лобової пазухи людини

Abstract

На сьогодні захворювання носа та приносових пазух становлять актуальну медичну проблему. Метою роботи було встановлення особливостей топографії та краніометричних характеристик лобових пазух людини залежно від статі. З урахуванням біоетичних норм досліджувалися лобові пазухи у 52 трупів людей обох статей, віком від 30 до 87 років. Вивчення топографії, форми та лінійних розмірів лобових пазух людини показали великий діапазон індивідуальних відмінностей. Форма лобових пазух буває різноманітною, але в більшості випадків нагадує тригранну піраміду, верхівка якої спрямована до вінцевого шва, основа – до верхньої стінки очної ямки. У будові лобових пазух людини простежується певна асиметрія; ліві синуси, зазвичай, більші за праві. Лобові пазухи людини мають тісний зв’язок з очною ямкою, передньою черепною ямкою, решітчастим лабіринтом і клиноподібною пазухою. У чоловіків, порівняно з жінками, лінійні розміри лобових пазух більші, проте їх різниця не є статистично значимою; На сегодня заболевания носа и околоносовых пазух являются актуальной медицинской проблемой. Целью работы было установление особенностей топографии и краниометрических характеристик лобных пазух человека в зависимости от пола. С учетом биоэтических норм исследовались лобные пазухи 52 трупов людей обоих полов в возрасте от 30 до 87 лет. Изучение топографии, формы и линейных размеров лобных пазух человека показали большой диапазон индивидуальных различий. Форма лобных пазух бывает разнообразной, но в большинстве случаев напоминает трехгранную пирамиду, вершина которой направлена к венечному шву, основание – к верхней стенке глазницы. В строении лобных пазух человека прослеживается определенная асимметрия; левые синусы обычно больше правых. Лобные пазухи человека имеют тесную связь с глазницей, передней черепной ямкой, решетчатым лабиринтом и клиновидной пазухой. У мужчин, по сравнению с женщинами, линейные размеры лобных пазух больше, однако их разница не является статистически значимой; Nowadays, the diseases of the nose and paranasal sinuses represent the current medical problem as the significant increase both in absolute numbers and in proportion in the structure of the common ENT pathology can be observed. This fact determines the considerable attention to the study of the paranasal sinuses, particularly frontal. Individual anatomical features of the frontal sinus structure, significant dependence of the nasal cavity on the state structures (ostiomeatal complex, nasal septum, scroll-bones, ect.), variability of symptoms, difficulties in examination and treatment indicate the need to improve traditional and develop new methods and ways in diagnostics of mentioned sinuses diseases. The solution of this problem is not possible without deep knowledge of anatomic-physiological features of the frontal sinuses. The aim of the study was to determine the topographic peculiarities and characterize the craniometric features of human frontal sinuses in relation to gender. Considering the bioethical norms the frontal sinuses in 52 cadavers of both genders, aged from 30 to 87 years whose death was not associated with pathology of paranasal sinuses have been investigated. The opening of the frontal sinus was performed from the cranial cavity. To determine the dependence of the frontal sinus size from the gender, the sagittal, vertical and linear sizes were determined by sliding caliper SC-1. The vertical size was determined from the frontonasal suture up to the highest point of the pyramid. The value of transverse size equaled to the distance from the septum between two frontal sinuses to the most distant point of the lateral angle of the frontal sinus. The sagittal size was equal to the distance from the posterior surface of the anterior wall of the frontal sinus to its posterior wall at the level of the supraorbital edge. Macroscopic study of the frontal sinus structure (sinus frontalis) has determined that human sinus structure has the significant range of individual differences in shape and size. The obtained data indicated that the frontal sinuses more often than supraorbital ridges were located slightly lateral reaching supraorbital incisure and posterior were about the front third of the upper wall of the orbit. In some cases the frontal sinuses were much dilated in the lateral direction, had additional cavities or septums. Sinus frontalis had the close correlation with the ocular fossa, anterior cranial fossa, ethmoidal labyrinth and sphenoid sinus. Especially clearly it was observed in case of pneumatic form of the frontal sinuses structure, when they had the large sizes and delicate walls. The shape of the frontal sinuses was quite varied, but in most cases it was similar to triangular pyramid, the tip of which was directed upwards to the coronal suture and the base downward to the upper wall of the orbit. The outlet of the sinus was located at its inferior wall next to the medial edge of the latter and opened into the middle nasal meatus under the end of the middle turbinated bone. The wide range of individual variability in the linear sizes of the frontal sinuses has been determined in research. In men compared with women, the linear sizes of the frontal sinuses were larger, but had no statistically significant difference (p>0.05). Thus, the largest sagittal size of the right frontal sinus in men was 23,4 mm, left – 22,68 mm. Their minimum sagittal sizes, respectively, were 8,62 and 8,58 9 mm. In men, the height of the right frontal sinus ranged from 35,56 to 12,02 mm, left – from 34,08 to 12 mm. Transversal size has also been changing: the right frontal sinus 32,54- 20,22 mm, left – 32,58-20,44 mm. In women the maximal sagittal size of the right frontal sinus was 22,22 mm, left – 23,24 mm. Their minimum sagittal sizes were, respectively, 8,44 and 7,94 mm. The height of the right frontal sinus in women ranged from 34,36 to 9,22 mm, left – from 32,79 to 12,22 mm. Transversal size has also been changing: for the right frontal sinus 32,43-19.8 mm, left − 32,08-19,76 mm. The average sagittal size of the right frontal sinus in men was 14,84±4,15 mm, left – 14,49±4,09 mm. In men the height of the right frontal sinus on average was 22,46±6,46, left – 22,73±6,15 mm. Transversal size, respectively, was 26,22±3,21 and 26,31±3,13 mm. In women the average sagittal size of the right frontal sinus was 14,48±4,09 mm, left – 14,39±4,09 mm. The height of the right frontal sinus in women on average was 22,32±6,00, left – 22,43±5,69 mm. Transversal size, correspondingly, was 26,072±3,58 and 26,21±3,5 mm.