额颞眶颧入路中动眼神经解剖研究

发布时间：2018-04-10 21:34

本文选题：面神经 + 动眼神经　；参考：《河北联合大学》2011年硕士论文

【摘要】：目的: 通过在10例国人尸头标本上采用额颞眶颧入路,(其中灌注7例,未灌注3例;男性6例,女性4例)对动眼神经及其周围结构观察和测量,为临床保护动眼神经及利用动眼神经周围相关间隙提供解剖学依据和参考。对象和方法: 1.应用灌注有彩色硅胶的尸头标本7例,未灌注3例模拟额颞眶颧入路逐层解剖,对颞区软组织层次和动眼神经及周围血管、蛛网膜结构进行精确测量和拍摄,观测与动眼神经相关间隙对颅底解剖结构的显露情况。 2.测量数据用SPSS13.0统计学软件处理后,以x士s(最小值min～最大值max)表示。结果: 1.面神经颞支分为前、中、后三支,前、中支在跨越颧弓上缘处,位于颞浅动脉主干前约1cm处,耳屏前2.4cm( 1.8～3.2cm)处;面神经颞支主要穿行于第Ⅰ、Ⅱ层脂肪垫中。 2.池段动眼神经和海绵窦上段动眼神经周围是蛛网膜汇集点,主要蛛网膜结构有liequist膜和动眼神经鞘;动眼神经入口与前床突和后床突的距离分别为11.24±4.32(6.13～18.06)mm和5.43±1.41 (2.63～7.08)mm。 3.海绵窦段动眼神经长、宽、高分别为16.52±3.08(12.86～20.09)mm、2.04±0.68(1.38～3.82)mm、1.53±0.46(1.06～1.94)mm;参与组成前内侧三角(Dolenc三角)、内侧三角(Hakuba三角)、旁内侧三角或Parkinson三角。 4.眶段动眼神经穿过眶上裂中央区,在入眶上裂前2～3mm处分为上、下2支;动眼神经与眶上裂上壁、内侧壁和外侧壁的距离分别为0.46士0.25(0.12～1.16)mm、1.78土0.55(0.48～3.10)mm和12.24士2.03(9.62～15.64)mm。 5.颈内动脉-小脑幕三角位于颈内动脉外侧和颞叶基底部之间,内侧边长为:8.23±2.87(5.76～11.03)mm,外侧边为7.24±1.87(5.32～9.62)mm,底边为5.78±2.24(3.16～8.02)mm;动眼神经外侧间隙中可见蛛网膜结构和小脑上动脉。结论: 1.动眼神经外侧间隙在处理基底动脉及其分支动脉瘤时有一定的辅助应用价值。 2.在海绵窦部,Parkinson三角和内侧三角联合入路几乎可显露海绵窦的所有结构和部位,因此临床上多应用这两个处理海绵窦的病变。该区域手术对动眼神经损伤率比较高。
[Abstract]:Objective:The oculomotor nerve and its surrounding structures were observed and measured in 10 cadavers of Chinese cadavers by frontotemporal orbital zygomatic approach (7 cases were perfused, 3 cases were not perfused, 6 cases were males and 4 cases were females).To provide anatomic basis and reference for clinical protection of oculomotor nerve and utilization of the space around oculomotor nerve.Objects and methods:1.Seven cadaver head specimens infused with color silica gel and 3 cases without simulated frontotemporal orbital zygomatic approach were dissected layer by layer to accurately measure and photograph the soft tissue level of temporal region, oculomotor nerve and surrounding vessels, arachnoid structure.The exposure of cranial base anatomical structure to the space related to oculomotor nerve was observed.2.The measured data were processed by SPSS13.0 statistical software and expressed as x + s (minimum min-max).Results:1.The temporal branches of the facial nerve were divided into anterior, middle and posterior branches. The anterior and middle branches were located about 1cm in front of the main trunk of superficial temporal artery and 2.4 cm (1.83.2cm) in front of the superficial temporal artery, and the temporal branch of facial nerve mainly passed through the first and second layers of fat pad.2.The oculomotor nerve in the cisternal segment and the oculomotor nerve in the superior cavernous sinus were surrounded by arachnoid junction, the main arachnoid structures were liequist membrane and oculomotor nerve sheath, the distance between the entrance of the oculomotor nerve and the anterior clinoid process and the posterior clinoid process was 11.24 卤4.32(6.13~18.06)mm and 5.43 卤1.41 卤1.41 卤2.63 ~ 7.08 mm. respectively.3.4.5.Conclusion:1.The lateral space of oculomotor nerve has some auxiliary application value in the treatment of basilar artery and its branches.2.In the cavernous sinus, Parkinson's triangle and medial triangle combined approach can reveal almost all structures and sites of cavernous sinus, so these two methods are often used in clinical treatment of cavernous sinus lesions.The rate of oculomotor nerve injury in this area is higher.
【学位授予单位】：河北联合大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R322

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