摘要
目的探讨海绵窦区解剖学新概念,为海绵窦区手术提供详实的解剖学依据。方法利用手术显微镜对经福尔马林固定、彩色乳胶灌注的国人成年尸颅21例进行手术观察、测量海绵窦区的硬膜关系、神经与血管走行及相邻结构的关系;利用组织化学技术对硬膜、神经及血管之间的关系进行组织学观察。结果中颅窝鞍旁两层硬膜形成一个腔,即鞍旁硬膜间腔;在鞍旁硬膜间腔内,硬脑膜结缔组织包裹动眼神经、滑车神经、外展神经、Meckel腔、三叉神经节及其三个分支组成一纵行板层样结构,我们称之为神经隔。颈内动脉及颅内、外静脉亦穿行于鞍旁硬膜间腔内;神经隔将海绵窦区分隔成硬膜间隙区、血液间隙区及床突间隙区。结论通过对海绵窦区显微外科解剖学研究,提出了该区构筑学新概念,为颅底手术经硬膜间隙侧壁入路提供了外科解剖学依据。
Objective To study the new concept of the microanatomy of cavernous sinus region and provide the detailed anatomical parameters for its operative approach, Methods The microsurgical dissections were performed on formahn-fixed and dye-injected cadaveric heads with the aid of microscope to observe and measure the dura, nerves and vessels in the cavernous sinus region, and to learn the relationships among the dura, nerves and vessels in the cavernous sinus region by histochemical technique. Results In middle cranial fossa, cavernous sinus and relevant anatomical structures were located in a cave made up of two floors of dum, namely dum mater space. Cranial nerves Ⅲ, Ⅳ, Ⅵ, the Meckels cave, the trigeminal ganglion and its three branches, which were enwrapped by arachnoid and dura, entered among the dura mater space, namely neuro-midriff, and internal carotid artery and some venous structures traveled among them. The dura mater space was divided into three parts by the neuro-midriff： ①The dura fissure： the outer part by which the extradural approach can be performed without the separation of trigeminal nerve branches; ②The blood fissure; ③The clinoid process fissure： located between the anterior chnoid process and the dural plate. Conclusion The study of the microsurgical anatomy of cavernous sinus can provide a new constructive conception about this region, which provides the surgical anatomical basis for the surgical approach.
出处
《中华神经外科疾病研究杂志》
CAS
2006年第4期338-341,共4页
Chinese Journal of Neurosurgical Disease Research
关键词
海绵窦
硬膜间腔
硬膜间隙
血液间隙
床突间隙
Cavernous sinus
Dura mater space
Dural fissure
Blood fissure
Clinoid process fissure
