摘要
目的研究颞下经小脑幕锁孔入路对岩斜-后海绵窦区结构的显微解剖,为临床应用该入路解决该区病变提供解剖学依据,同时探讨它在处理岩斜-后海绵窦区病变时的局限性。方法应用福尔马林固定的成人湿性头颅标本10例20侧,模拟颞下经小脑幕锁孔入路对岩斜-后海绵窦区进行显微解剖观察。结果颞下经小脑幕锁孔入路可以清楚暴露小脑幕上中颅底及后海绵窦结构,切开小脑幕后可以暴露动眼神经、滑车神经、三叉神经、环池、后交通动脉、基底动脉顶部、大脑后动脉、中脑的前外侧部等结构。但由于岩骨嵴的阻挡,无法观察岩骨后颅窝面。结论颞下经小脑幕锁孔入路完全能达到传统颞底大骨瓣开颅对岩斜-后海绵窦区的暴露范围,同时具有创伤小、易于操作的优点,但处理基底位于岩骨后颅窝面的大型岩斜区肿瘤存在一定的局限性。
Objective To study the micro-anatomic structure of petroclival region and post-cavernous sinus via subtemporal transtentorial keyhole approach,and provide anatomic basis in clinical use to deal with the disease in this area.Meanwhile,the limitations of this approach can be chiscussed.Methods Ten formalin-fixed adult cadaver heads of twenty sides were used for simulating subtemporal transtentorial keyhole approach to observe the structure of petroclival region and post-cavernous sinus.Results Through this approach the mid-skull base above tentorial and the cavernous sinus could be easily exposed.The oculomotor nerve,trochlear nerve,trigeminal nerves,cisterna ambiens,posterior communicating artery,cupular part of basilar artery,posterior cerebral artery,the ante-lateral mesencephalon and so on could be exposed after opening the tentorial.But the os petrosum face to posterior cranial fossa could not be seen because of the hinder of os petrosum.Conclusion The subtemporal transtentorial keyhole approach has the same exposure like the traditional subtemporal approach,it minimize the trauma and can be operated easily.But it has some limitations in dealing with large tumors in petroclival region when the base of the tumor locates on the petrous bone face to the posterior cranial fossa.
出处
《苏州大学学报（医学版）》
CAS
北大核心
2010年第1期42-44,共3页
Suzhou University Journal of Medical Science
关键词
颞下经小脑幕入路
锁孔入路
岩斜区
subtemporal transtentorial approach
keyhole approach
petroclival region
