摘要
目的进行颞下锁孔入路解剖学结构研究,为临床颞下锁孔入路手术入路提供解剖依据。方法在显微镜下对6例经甲醛固定的国人成人尸头模拟颞下锁孔入路手术进行解剖,测量重要神经血管及其相关结构之间的距离以及观察显露范围和相关解剖关系。结果颧弓至小脑幕缘、脑干和前床突的最短距离分别为41.1±5.1mm、45.6±3.3mm和61.1±7.4mm。颞骨岩部扩大磨除前后显露的Day菱形区面积有显著差异(P<0.05)。颞下锁孔入路可清楚的显露海绵窦外侧壁上的各神经血管及三角,鞍侧区可清晰的显露颈内动脉、后交通动脉及其穿支、脉络膜前动脉和垂体柄,磨除颞骨岩尖部可显著增加岩斜区脑干显露。结论颞下锁孔入路对于海绵窦外侧壁,岩斜区及鞍侧区显露效果好,入路简单直接,组织损伤小。
Objective To provide an anatomy base for the microsurgery through subtemporal keyhole approach.Methods Sixs pecimen of formalin-fixed cadaveric heads were dissected by simulating the microsurgery through subtemporal keyhole approach.Then eurovascular structures related to the microsurgery through the subtemporal keyhole approach were observed and the distance amongt hem were measured.The extent of exposure of the structures related to this approach was described.Results The shortest distances fromt he zygomatic arch to the tentorial edge,brain stem and anterior clinoid process were（41.1±5.1）mm,（45.6±3.3）mm and（61.1±7.4）mmr espectively.The area（279.7±45.4）mm 2 was significantly bigger after the expansive effacement of the petrous bone than that（235.7±37.7）m m2 before the expansive effacement of the petrous bone（P0.05）.The nerves,vessels and the triangle which were in lateral wall of thec avernous sinus was clearly exposed by the microsurgery through subtemporal keyhole approach,by which,internal carotid artery,p osterior communicating artery and their branches,anterior choroidal artery and hypophysial stalk lateral to the saddle area were exposeda lso.The brain stem in the petroclival region was exposed better after the effacement of the apex of the temporal bone compared to thatb efore the effacement of it.Conclusions The nerves,vessels and the other structures lateral to cavernous sinus and saddle area,may bee xposed well by microsurgery through subtemporal keyhole approach,which produces only relatively little damage to the cerebral tissues.
出处
《中国临床神经外科杂志》
2010年第4期219-222,共4页
Chinese Journal of Clinical Neurosurgery
关键词
颞下锁孔
海绵窦
岩斜区
鞍侧区
解剖学
Subtemporal keyhole approach Cavernous sinus Saddle area Petroclival region Anatomy
