摘要
目的观察颈内动脉床突段的解剖特点,探讨该结构的毗邻关系,为临床工作的开展提供依据。方法成人尸头标本7例,分别以红色和蓝色硅胶对动脉、静脉进行灌注;应用显微解剖技术,观察并测量颈内动脉的床突段及与眼动脉、远/近侧硬膜环等重要毗邻结构的位置关系。结果 (1)与颈内动脉床突段相关的参数:床突段的外径为(5.11±0.81)mm,床突段外侧面远、近侧硬膜环中点间距离为(5.46±1.90)mm,远侧硬膜环形成颈内动脉窝的出现率约为78.6%。(2)床突段与眼动脉的关系:①眼动脉起点与远侧硬膜环的位置关系为近侧约7.1%、恰于远环处约14.3%、远侧78.6%;②眼动脉起点与颈内动脉横截面的位置关系为内1/3约78.6%、中1/3约21.4%(未观察到外1/3的情况)。结论 (1)术前影像学检查十分必要。(2)对侧翼点入路有利于眼动脉起点处病变的暴露。(3)提出两点术中注意事项:①环切远侧硬膜环时,应注意避免伤及眼动脉或其它视神经管内结构;②磨除前床突时注意其内侧的重要血管、神经组织,应以邻近硬膜瓣加以保护。
Objective To explore anatomic features and relationships of clinoid segment of internal carotid artery（ICA）,and provide anatomic basis for clinic application.Methods By dissecting seven adult cadaveric heads perfused with red and blue latex into arteries and veins separately under the operating microscope,anatomic details related to the clinoid segment of ICA were explored.Results 1） The diameter of clinoid segment was about（5.11±0.81）mm;the distance between the midpoints of distal and proximal carotid dural rings was（5.46±1.90）mm.The incidence of ICA cave was about 78.6%.2） For most specimens（78.6%）,ophthalmic artery（OA） was sent out above the medial one-third of the superior surface of ICA,others（21.4%） the middle one-third（no one from the lateral one-third）.3） OA originated proximally to the distal ring in 7.1%,distally in 78.6%,or closed to the distal ring in 14.3%.Conclusions 1） Preoperative arteriogram is indispensable for clinic treating.2） Contralateral pterional approach is valuable to expose the origin of OA.3） OA and other structures in optic canal should be protected during circumferential dissection of the distal ring,as well the adjacent vessels and nerves when removing the anterior clinoid process.
出处
《中国临床解剖学杂志》
CSCD
北大核心
2012年第1期8-11,共4页
Chinese Journal of Clinical Anatomy
关键词
颈内动脉
床突段
动脉瘤
显微解剖
Internal carotid artery
Clinoid segment
Aneurism
Microanatomy
