前床突及相关区域显微解剖研究

发布时间：2018-01-14 04:22

本文关键词：前床突及相关区域显微解剖研究　出处：《山东大学》2005年硕士论文　论文类型：学位论文

【摘要】：目的:前床突(ACP)是前、中颅窝的分界点,又是视神经、颈内动脉外侧的保护标志,因此,前床突有着重要的解剖意义。其位置重要,对于该区域的病变,需要考虑如何通过磨除前床突获得手术操作空间是近几年来研究的热点和难点。为取得国人此方面的资料,为临床眶上裂及海绵窦区域病变的显微外科手术入路提供解剖学参数依据,本研究通过显微镜下对尸体头颅的解剖、测量,明确前床突与周围结构的解剖关系,并对高度个体化的骨性结构、神经、血管、硬膜等的解剖关系进行分析统计,我们设计了此项研究。方法:应用10%福尔马林充分固定的国人成人尸头湿标本10例20侧,无法确切地判定年龄和性别,为更准确地区分动静脉,维持血管正常粗细和提高拍摄质量,所有头颅湿标本均在动脉系统灌注混有红色染料的乳胶,静脉系统灌注混有蓝色染料的乳胶。漂白的国人成人颅骨干标本15例30侧,供骨性结构的观察和测量。选择前外侧方手术最有代表性的额颞开颅(翼点)入路进行详细研究,在手术显微镜下,模拟手术入路逐层解剖,结合影像解剖学,对解剖结构进行精确测量和拍摄,所得数据均经SPSS处理,以平均数(测量值范围)的形式表现。结果:1.ACP前外下方为眶上裂,前外与蝶骨小翼连接,前内与视神经管顶部后缘及视柱相连结,内侧有颈内动脉通过,外下侧有海绵窦。ACP状如锥形,其长、宽、厚分别为9.82±1.24(7.54-12.52)mm,12.77±2.51(8.78-17.84)mm,5.69±1.39(3.36-9.74)mm。可通过硬膜内外联合法磨除,注意其下缘紧贴着海绵窦外侧壁内的颅神经。 2.床突间隙(clinoid process space)是磨除前床突后人为形成的一锥形腔隙,尖端指向后方,毗邻组织与前床突存在时大致相同。其空间大小与前床突及周围组织结构的构成、范围和边缘的大小有很大的关系,其中全颈内动脉(ICA)
[Abstract]:Objective: anterior clinoid process (ACP) is the dividing point of anterior and middle cranial fossa as well as the protective marker of optic nerve and lateral internal carotid artery. Therefore the anterior clinoid process has important anatomical significance and its location is important. For the lesions in this area, it is a hot and difficult point to study how to obtain the operation space by removing the anterior clinoid process in recent years. In order to provide anatomic parameters for microsurgical approach of supraorbital fissure and cavernous sinus lesions, the anatomical relationship between anterior clinoid process and surrounding structure was determined by microscopical anatomy of cadaveric head. The anatomical relationships of osseous structures, nerves, blood vessels and dura dura were analyzed and analyzed. Methods: 10 cases and 20 sides of wet head specimens of Chinese adult cadavers which were fully fixed with 10% formalin were used. It was impossible to determine age and sex accurately, so as to distinguish artery and vein more accurately. To maintain normal vascular thickness and improve shooting quality, all head wet specimens were infused with red dyed latex in the arterial system. The venous system was infused with blue dye emulsion. Bleached adult skull specimens were collected from 15 cases (30 sides). To select the most representative frontotemporal craniotomy (pterional) approach for detailed study, under the surgical microscope, simulate the surgical approach layer by layer anatomy, combined with image anatomy. The anatomical structure was accurately measured and photographed, and the obtained data were processed by SPSS and represented as the average (range of measured values). Results 1. The superior orbital fissure was located below the anterior and outer part of ACP, the anterior and outer part was connected with the pterygoid of the sphenoid bone, the anterior and outer part was connected with the apical and posterior edge of the optic canal and the optic column, the internal carotid artery passed through the medial side. The lateral cavernous sinus. ACP shape is conical, its length, width and thickness are 9.82 卤1.247.54-12.52 mm respectively. 12.77 卤2.51g 8.78-17.84mm. 5.69 卤1.39n3.36-9.74mmm. it can be milled by the combination of epidural and extradural methods. Note that the lower margin is close to the cranial nerve in the lateral wall of the cavernous sinus. 2. Clinoid process space is a conical space formed by grinding the anterior and posterior clinoid processes, with the tip pointing to the rear. The size of the adjacent tissue is similar to that of the anterior clinoid process, and the size of the space is closely related to the structure of the anterior clinoid process and the surrounding tissue, the range and the size of the margin, in which the total internal carotid artery (ICA)
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2005
【分类号】：R651;R322

【引证文献】