侧颅底外科颞盂入路的应用解剖研究

发布时间：2018-12-18 04:51

【摘要】：【目的】研究侧颅底手术径路之一—颞盂入路的相关应用解剖，为此手术入路提供翔实的解剖学理论基础和实践依据。【方法】通过对5具成人湿性尸头模拟颞盂入路联合乳突或乳突—枕下—颈入路进行解剖，明确手术径路中穿经结构以及重要血管神经的相互毗邻关系；通过对53具成人颅骨观察测量侧颅底区骨性结构的临床应用解剖，为手术中准确定位侧颅底相关重要解剖结构，保全颅神经和重要血管提供较翔实的解剖学依据。【结果】①颞盂相关解剖：以矢状面为基准，颞盂前后径为颧突关节结节最下点至鼓乳裂最下点间最短距离，左侧为30.3±2.3mm、右侧为30.4±2.4mm，颞盂左右径为关节后突最下点至颈静脉窝最短距离，左侧为21.0±2.4mm、右侧为20.1±2.4mm，下颌关节窝的前后径为颧突关节结节最下点至关节后突最下点间最短距离，左侧为18.0±2.0mm、右侧为17.8±1.9mm。②颞盂毗邻相关解剖：颞盂外侧起始标志关节后突最下点、鼓乳裂最下点这两点与侧颅底重要神经血管穿经孔隙(茎突根、茎乳孔外缘、颈静脉球窝外缘、颈动脉管口外缘、舌下神经管外口外缘、枕骨髁外缘、卵圆孔外缘、棘孔外缘、蝶棘)的最短距离和这两点与这些孔隙的夹角分别在表1～4中描述。③颈静脉球窝解剖：测量分别以冠状面、矢状面为基准的最长径线，左侧为14.2±2.1mm、7.3±1.6mm，右侧为15.5±2.0mm、9.7±2.0mm。左右两侧对比经卡方检验结果P＜0.05，有统计学意义，，可以认为颈静脉球窝左右两侧大小不同。④茎乳孔至颈静脉球窝间最短距离，左
[Abstract]:[objective] to study the applied anatomy of temporopelvic approach, one of the operative approaches of lateral skull base, and to provide a theoretical and practical basis for the surgical approach. [methods] five adult cadaveric cadavers were dissected via the combined mastoid or mastoid-suboccipital cervical approach to determine the structure of the surgical approach and the relationship between the important vessels and nerves. The clinical applied anatomy of bone structure in lateral skull base region was observed and measured in 53 adult skulls, which provided a more accurate anatomic basis for locating the important anatomical structure of lateral skull base and preserving cranial nerves and important blood vessels. [results] 1Temporopelvic related anatomy: according to the sagittal plane, the anterior and posterior diameters of temporal pelvis were the shortest distance between the lowest point of zygomaticoid process joint nodule and the lowest point of tympanomastoid fissure, the left side was 30.3 卤2.3 mm, the right side was 30.4 卤2.4 mm. The right and left diameters of temporal pelvis were the shortest distance from the lowest point of posterior process to the fossa of jugular vein, 21.0 卤2.4 mm on the left and 20.1 卤2.4 mm on the right. The anteroposterior diameter of the mandibular fossa was the shortest distance between the lowest point of zygomaticoid process joint nodule and the lowest point of posterior articular process. The left side was 18.0 卤2.0 mm, and the right side was 17.8 卤1.9mm.2 adjacent anatomy of the temporal glenoid: the lateral temporopelvic origin marks the inferior point of the articular process, the lowest point of the tympanic and mammary fissure, and the important nerve vessels of the lateral skull base through the pore (styloid root). The external margin of stylomastoid foramen, jugular fossa, carotid canal orifice, hypoglossal nerve canal, occipital condyle, foramen ovale, foramen spinosus, etc. The shortest distance of sphenoid spine and the angle between these two points and these pores are described in Table 1.3. Anatomy of the Glomus jugular fossa: measurement of the longest diameter based on coronal plane and sagittal plane, left side is 14.2 卤2.1 mm-1 mm 7.3 卤1.6 mm, The right side was 15.5 卤2.0mm and 9.7 卤2.0mm. The results of chi-square test showed that the size of the jugular fossa was different between the right and left sides. 4 the shortest distance between the caudomastoid foramen and the jugular fossa was left.
【学位授予单位】：福建医科大学
【学位级别】：硕士
【学位授予年份】：2006
【分类号】：R322

【相似文献】