颞下经下颌入路显露侧颅底区的应用解剖学研究

发布时间：2018-05-16 01:19

  本文选题：显微解剖 + 经下颌入路　； 参考：《南京医科大学》2005年硕士论文

【摘要】：第一部分 颞下经下颌入路显露侧颅底区的显微解剖学研究 目的 详尽了解颞下经下颌入路显露侧颅底区的显微解剖结构,为临床应用提供解剖学参数,从而提高侧、中颅底区沟通性肿瘤的手术疗效,设计并进行此项研究。 方法 选用成人尸头10例(20侧),模拟颞下经下颌手术入路,解剖、观察、测量相关结构,探求入路涉及的肌肉、神经血管间的解剖关系。所得数据均经统计学处理,以平均数±标准差(测量值范围)的形式表示。 结果 面神经额颞支走行于颞浅筋膜和颞深筋膜浅层之间或颞浅筋膜内。颞下窝和翼腭窝血管神经丰富,翼外肌占据着颞下窝的大部分空间。上颌动脉是颈外动脉两终支中较大的一支,其颞下窝内的走行可被分成下颌部、翼肌部和翼腭部三段,其中下颌部位于下颌关节囊下方20.4±1.7mm(16.8-23.4),翼肌部和翼腭部行程变异较大。翼静脉丛有深浅两部分,本研究观察深部较为明显。下颌神经分主司运动的前外侧股和主司感觉的后内侧股。茎突及其筋膜将咽旁间隙分为茎突前和茎突后间隙,后者容纳颈内静脉、颈内动脉和Ⅸ,Ⅹ,Ⅺ,Ⅻ颅神经。 结论 颞下经下颌入路用于切除位于颞下窝、翼腭窝、咽旁间隙及中颅窝底的肿瘤,尤其是侧、中颅底区巨大沟通性肿瘤。该入路暴露充分,涉及解剖复杂,系统全面地掌握相关解剖知识是应用该入路的必要前提。
[Abstract]:The first part: microanatomical study on the exposure of lateral skull base area by subtemporal approach via mandibular approach Objective to investigate the microanatomical structure of lateral skull base by subtemporal and mandibular approach in order to provide anatomical parameters for clinical application and to improve the surgical efficacy of communicating tumors in lateral and middle skull base. Methods Ten cadaveric cadavers with 20 sides were used to simulate the subtemporal transmandibular approach, dissection, observe and measure the related structures, and explore the anatomical relationship between the muscles, nerves and vessels involved in the approach. The data were statistically processed and expressed as mean 卤standard deviation (range of measured values). Results the frontotemporal branch of the facial nerve was located between the superficial temporal fascia and the superficial layer of the deep temporal fascia or within the superficial temporal fascia. The infratemporal fossa and pterygopalatine fossa are abundant in blood vessels and nerves. The maxillary artery is the larger of the two terminal branches of the external carotid artery. The path in the infratemporal fossa can be divided into three segments: the pterygoid muscle and the pterygopalatine. The mandible is located below the mandibular joint capsule 20.4 卤1.7mm and 16.8-23.4m, and the distance between the pterygoid muscle and the pterygoid is more variable. The pterygoid venous plexus is deep and shallow. The mandibular nerve is divided into the anterolateral thigh of the main division motion and the posterior medial thigh of the main division sensation. The styloid process and its fascia divide the parapharyngeal space into the anterior-styloid space and the poststyloid space, the latter accommodating the internal jugular vein, the internal carotid artery and IX, 鈪，

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