岩上静脉的应用解剖及其在显微血管减压术中的意义

发布时间：2018-05-06 17:50

本文选题：岩上静脉 + 神经解剖学　；参考：《中国微侵袭神经外科杂志》2006年07期

【摘要】：目的研究岩上静脉的解剖特点,为临床施行显微血管减压术提供应用解剖学资料。方法取15例(30侧)成人尸头标本,经静脉乳胶灌注处理后,在手术显微镜下观察和测量岩上静脉的位置、形态、分支及变异等情况,以及与三叉神经、面神经、位听神经等的毗邻关系。对60例三叉神经痛或面肌痉挛病人施行显微血管减压术,术中观察岩上静脉及其属支的各项情况。结果①岩上静脉位于蛛网膜下腔间隙内,呈游离悬空状,多由2￣3支属支静脉汇成,最终注入岩上窦的内、中2/3段。其属支静脉起自小脑半球的前缘部分和脑桥腹侧面,岩上静脉主干之间或两侧的岩上静脉之间存在交通连接。②根据尸头单侧岩上静脉的数量,可以将其分为单干型(9侧,30.0%)、双干型(17侧,56.7%)和三干型(4侧,13.3%);根据55支岩上静脉注入岩上窦的位置与内听道的关系,可将其分为内侧组(17支,30.9%)、中间组(24支,43.6%)和外侧组(14支,25.5%)。临床所见与解剖结果基本一致。③岩上静脉的主干或属支与三叉神经密切相关,可与三叉神经直接接触,形成压迫。没有见到岩上静脉或其属支与面神经、位听神经相接触形成压迫的情况。结论岩上静脉是颅后窝最大的和最常遇到的静脉,其主干和属支在走行过程中与三叉神经、面神经和位听神经相毗邻,并且可以对三叉神经形成压迫。在显微血管减压术中,对作为责任血管和阻挡手术入路的岩上静脉或其属支静脉,可以完全切断。
[Abstract]:Objective to study the anatomical characteristics of superior petrosal vein and to provide applied anatomical data for clinical microvascular decompression. Methods Fifteen adult cadaveric heads were collected and treated by intravenous emulsion infusion. The position, morphology, branching and variation of the superior petrosal vein were observed and measured under the operation microscope, and the specimens were associated with the trigeminal nerve and the facial nerve. The adjoining relationship of the auditory nerve, etc. Microvascular decompression was performed in 60 patients with trigeminal neuralgia or hemifacial spasm. Results 1 the superior petrosal vein was located in the space of the subarachnoid space and was free suspended. The vein was mostly composed of 2 or 3 branches, and was finally injected into the superior petrosal sinus with a middle 2 / 3 segment. Its branch vein originates from the anterior part of the cerebellar hemisphere and the ventral side of the pontine, and there is a communication connection between the main trunk of the superior petrosal vein or between the two superior petrosal veins. 2 according to the number of unilateral superior petrosal veins in the cadaveric head, According to the relationship between the position of superior petrosal vein injection and the internal auditory canal, it can be divided into medial group (n = 17), middle group (n = 24) and lateral group (n = 14). The clinical findings are consistent with the anatomical results. 3 the trunk or branch of the superior petrosal vein is closely related to the trigeminal nerve and can be directly contacted with the trigeminal nerve to form compression. There was no compression of the superior petrosal vein or its branches in contact with the facial nerve and auditory nerve. Conclusion the superior petrosal vein is the largest and most frequently encountered vein in the posterior cranial fossa. Its trunk and branch are adjacent to the trigeminal nerve, the facial nerve and the position auditory nerve in the course of walking, and can compress the trigeminal nerve. During microvascular decompression, the superior petrosal vein or its branch vein, which acts as the responsible vessel and obstructs the operative approach, can be completely severed.
【作者单位】：大连大学附属中山医院神经外科大连医科大学基础部解剖学教研室大连大学附属中山医院神经外科大连大学附属中山医院神经外科大连大学附属中山医院神经外科大连大学附属中山医院神经外科大连大学附属中山医院神经外科大连大学附属中山医院神经外科大连大学附属中山医院神经外科
【分类号】：R651.1

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