枕下正中经小脑延髓裂锁孔入路的显微解剖研究

发布时间：2018-06-01 20:23

本文选题：入路 + 小脑延髓裂　；参考：《中国微侵袭神经外科杂志》2016年12期

【摘要】：目的通过枕下正中经小脑延髓裂锁孔入路对第四脑室及其周围结构进行显微解剖观察,为临床应用提供解剖学依据。方法在10具(共20侧)成人尸头标本上模拟枕下正中经小脑延髓裂锁孔入路,使用显微镜对第四脑室及其周围组织结构进行解剖、观察和相关数据测定。结果 (1)枕下正中经小脑延髓裂锁孔入路可暴露第四脑室底、外侧隐窝、中脑导水管开口和脑干侧方等。(2)该入路可暴露的第四脑室底长度(37.73±0.77)mm,宽度(17.12±0.52)mm,面积(319.70±14.25)mm~2。(3)10具尸头共发现小脑后下动脉(PICA)19侧,PICA缺如1侧。同一标本双侧PICA直径差异较大,PICA下袢位置的变异也较大。结论 (1)枕下正中经小脑延髓裂锁孔入路对第四脑室的暴露范围与常规小脑延髓裂入路相仿,但存在显露角度受限、深部结构视野不佳等不足。(2)PICA与小脑延髓裂关系密切,且PICA走行分布复杂多变,术中应仔细辨认,避免误伤。
[Abstract]:Objective to observe the microanatomy of the fourth ventricle and its surrounding structures through the suboccipital median approach through the keyhole approach of the medulla oblongata so as to provide anatomic basis for clinical application. Methods 10 adult cadaver heads (20 sides) were used to simulate the suboccipital median approach through the keyhole of medulla oblongata. The structure of the fourth ventricle and its surrounding tissues were dissected by microscope and the relevant data were measured. Results 1) the suboccipital median approach via the keyhole of the medullary fissure of the cerebellum exposed the floor of the fourth ventricle and the lateral recess. The length of the floor of the fourth ventricle was 37.73 卤0.77 mm, the width was 17.12 卤0.52 mm, and the area was 319.70 卤14.25)mm~2.(3)10. One side of the posterior inferior cerebellar artery (PICA) was found to be absent in 19 sides of the posterior inferior cerebellar artery. The diameters of PICA in both sides of the same specimen were quite different, and the variation of the position of the lower loop of PICA was also significant. Conclusion (1) the exposure to the fourth ventricle via the median suboccipital approach via the keyhole of the cerebellar fissure is similar to that of the conventional approach, but the exposure angle is limited, and the deep structure of visual field is not good. The PICA is closely related to the cerebellar medullary fissure. Moreover, the distribution of PICA is complex and changeable, so it should be recognized carefully during operation to avoid accidental injury.
【作者单位】：安徽医科大学第一附属医院神经外科;
【基金】：安徽省科技攻关项目(编号:12010402113)
【分类号】：R322.8

【相似文献】