摘要
目的:探讨卵圆孔解剖结构对经皮穿刺微球囊压迫术治疗三叉神经痛的意义。方法:选择20例(40侧)离体头颅标本,行眉弓上水平位切开,观察卵圆孔形态并测量解剖结构。以标本口角旁开2~3 cm为穿刺点,测量经卵圆孔穿刺半月节时,穿刺针与头颅冠状面、矢状面、水平面的角度,并观察穿刺针进针深度范围内与海绵窦内组织关系。结果:40侧标本中,卵圆孔多呈卵圆形,其中2例呈长条形。平均长径6.6±1.3 mm,横径3.8±1.0 mm。卵圆孔外缘至正中矢状线平均距离26.1±7.0 mm,卵圆孔前缘至颅底前缘平均距离76.9±10.3 mm。头颅标本自口角旁2~3 cm穿刺至卵圆孔段平均深度77.6±10.2 mm,卵圆孔至三叉神经半月节段长度14.3±4.5 mm。穿刺针与矢状面成角30.1°±10.0°,与冠状面成角37.9°±15.8°,与水平面成角63.4°±13.6°。结论:卵圆孔解剖复杂且个体差异较大,穿刺过程中穿刺针保持一定的深度及角度有助于准确经卵圆孔到三叉神经节,进而保证临床手术的安全性。
Objective: To study the anatomic structure of foramen ovale in percutaneous microballoon compression for the treatment of trigeminal neuralgia. Methods: We selected 20 cases(40 sides) severed head specimens and incised the specimens horizontally on the eyebrow arch with the skull base and craniotomy instruments, then observed the shape of foramen ovale and measured the anatomic structure. We inserted the trigeminal ganglion via foramen ovale from the position where 2-3 cm to the side of the specimens and measured the angle between the puncture needle and the human coronal plane, the vertical plane, the horizontal plane with conimeter. Finally, the relationship between the puncture needle and internal tissues of cavernous sinus in the depth of penetration of the needle were analyzed. Results: The shape of the foramen ovale of 38specimens are oval and 2 of that are long strip. The mean major diameter of foramen ovale is 6.6±1.3 mm,the transverse diameter is 3.8±1.0 mm. The distance from the outer edge of the foramen ovale to the median sagittal line is 26.1±7.0 mm, the distance from the leading edge of the foramen ovale to the frontal edge of the skull base is 76.9±10.3 mm. The depth from the position where 2-3 cm to the side of the specimens to the foramen ovale is 77.6±10.2 mm, the length from foramen ovale to the trigeminal ganglion is 14.3±4.5 mm. The angle between the puncture needle and the vertical plane is 30.1°±10.0°, between the puncture needle and the coronal plane is 37.9°±15.8°, between the puncture needle and the horizontal plane is 63.4 °±13.6°.Conclusion: The anatomy about foramen ovale is of great complexity and individual differences. The depth and angle the puncture needle maintains on the puncture route is important to the accurate penetration through the foramen ovale and also important to the safety of the operations.
作者
靳子娟
王晶晶
李云
赵旭
朱军
赵然
卢嘉亮
郑文扬
吴桐
杨鹏
JIN Zijuan;WANG Jingjing;LI Yun;ZHAO Xu;ZHU Jun;ZHAO Ran;LU Jialiang;ZHENG Wenyang;WU Tong;YANG Peng(Department of Neurosurgery,North China University of Science and Technology Affiliated Hospital,Tangshan 063000,China;Department of Preventive Medicine,School of Public Health,North China University of Science and Technology,Tangshan 063210,China)
出处
《中国疼痛医学杂志》
CAS
CSCD
北大核心
2023年第1期20-23,共4页
Chinese Journal of Pain Medicine
基金
河北省医学科学研究课题计划(20221530)。
关键词
卵圆孔
三叉神经痛
解剖结构
foramen ovale
trigeminal neuralgia
anatomic structure
