摘要
目的研究中岩斜区神经血管间的关系及其分布和走行特点、血管穿支的分布特点等,为中岩斜区的手术提供显微解剖学基础。方法用15例血管经彩色乳胶灌注的成人尸体头颅,在镜下从不同方向研究中岩斜区神经血管的走行分布特点、神经和血管间及其与周围结构间的显微解剖关系。结果磨除三叉神经节外下方颞骨岩部尖的骨质后,三叉神经可向下、向外移动。小脑前下动脉的走行可分为,桥脑前段、桥脑外侧段、小脑外侧间裂段和皮质段。当一侧的小脑后下动脉缺如时则为同侧的小脑前下动脉所替代,小脑前下动脉在四段中均有穿支供应桥脑或延髓,小脑前下动脉可与Ⅴ、Ⅵ、Ⅶ、Ⅷ相接触,其中与Ⅶ、Ⅷ的关系最为复杂。基底动脉(BA)的走行变异很大,高位的BA头端在本组占33.3%。其全程发出桥支,供应桥脑的腹侧或外侧。结论(1)中岩斜区神经血管结构众多而复杂,全面而系统地掌握中岩斜区的显微解剖是策划中岩斜区手术入路、减少术中并发症的重要前提和保证。(2)小脑前下动脉在中岩斜区有较多的穿支供应脑干和颅神经,手术中要尽量避免损伤。
Objective To provide anatomical basis for operation of middle petroclival region through studying the relationship between nerves and arteries and their perforating arteries＇ behaviores of distribution and course in the middle petroclival region. Methods To study the behavior of distribution and course of nerves and arteries, the anatomical relationship of the arteries to nerves and adjacent structures was observed in 15 cadaveric adult heads, whose arteries had been injected with colored silicone through different directions under microscope. Results Trigeminal nerve can be moved downwards and forth after drilling the apex of petrous bone lateral inferior to trigeminal ganglion. The course of anterior inferior cerebella artery（AICA） can be divided into 4 segments., anterior pontine segment, lateral pontine segment, lateral cerebellar fissure segment and cortical segment. PICA can be replaced by the same side AICA when there is a lack of PICA. AICA has perforating arteries to supple the pons or medulla in each segment. AICA contacts withⅤ,Ⅵ,Ⅶ,Ⅷ and the relationship between AICA and Ⅶ,Ⅷ is most complex. The course of basilar artery（BA） has great variation and the higher apex of BA is 33.3%, BA gives off perforating arteries to supply lateral or ventral pons in each segment. Conclusions （1） Because there are more and complex nerves and blood vesseles in the middle petroclival region,an overall and systemic mastery of it＇s microanatomy is an important prerequisite and assurance to plan the operative approach and to reduce operative complications. （2）Many perforating branches of AICA supply brain stem in middle petroclival region, so they should not be injuried during operation.
出处
《江苏医药》
CAS
CSCD
北大核心
2005年第8期568-570,i0003,共4页
Jiangsu Medical Journal
