颅中窝经颞下手术入路的显微解剖研究

发布时间：2019-05-24 14:11

【摘要】：前言颅中窝经颞下入路是显微神经外科的一种常用手术入路,主要用于处理颅中窝硬膜内、外肿瘤、高血压病脑出血、中颅窝部位外伤性颅内血肿、三叉神经后根切断术、颞肌下减压术、面神经减压术等疾病。本研究结合临床实际手术操作进行尸头解剖,探讨该解剖路径上的重要解剖结构,同时选择翼点和颧弓点作为颅中窝手术入路的观测点,对翼点、颧弓点至颅中窝各结构的距离与夹角进行测量,并测量面神经管裂孔至棘孔(FS)、弓状隆起、内耳门的连线长度和各连线与正中矢状面成角。探讨各结构间的位置关系,为临床手术提供解剖学依据。实验材料与方法 1 材料 1.1 实验对象 10例(20侧)甲醛固定的正常成人尸体头颅标本(由中国医大局解教研室提供),其中7例为男性头颅、3例为女性头颅,经动、静脉系统分别灌注混有红色和蓝色染料的乳胶,以维持血管正常粗细及易于辨认。 1.2 实验器械及试剂临床神经外科常规手术器械(由中国医大局解教研室提供)、高压注射器、开颅器、乳胶原液(沈阳市乳胶厂提供)、游标卡尺(精确度0.02)、量规、量角器、铅丝、照相机、可放大5—20倍的手术显微镜等。 2 方法 2.1 乳胶原液灌注尸头动、静脉系统于标本颈部断面钝性分离一侧颈内动脉(ICA)2cm,置入除去尖端的粗针头,7号手术缝线双重结扎,利用高压注射器通过针头将红色乳胶原液注
[Abstract]:The subtemporal approach of the middle fossa is a common surgical approach in microneurosurgery, which is mainly used to deal with intradural and external tumors of the middle fossa, hypertensive intracerebral hemorrhage and traumatic intracranial hematomas in the middle fossa. Posterior trigeminal rhizotomy, subtemporal decompression, facial decompression and other diseases. In this study, the cadaveric head was dissected in combination with clinical operation, and the important anatomical structure on the anatomical path was discussed. At the same time, the pterygoid point and zygomatic arch point were selected as the observation points of the surgical approach to the middle fossa of the skull, and the pterygoid points were selected. The distance and angle between zygomatic arch point and middle fossa were measured, and the (FS), arcuate eminence from facial nerve canal foramen to spinous foramen was measured. The length of the inner auriculus and the angle between each line and the median sagittal plane were measured. To explore the position relationship among the structures, and to provide anatomical basis for clinical surgery. Experimental materials and methods 1 material 1.1 10 cases (20 sides) of formaldehyde fixed normal adult cadaveric head markers This (provided by the Department of Teaching and Research of the Chinese Medical University), Among them, 7 cases were male head and 3 cases were female head. Latex mixed with red and blue dye was perfused through artery and vein system to maintain the normal thickness and easy identification of blood vessels. 1.2 Experimental instruments and reagents conventional surgical instruments in clinical neurosurgery (provided by the Department of Local solution, Chinese Medical University), high pressure syringes, craniotomy devices, latex solution (provided by Shenyang Latex Factory), Vernier calipers (accuracy 0.02), gauges, angle gauges, lead wires, cameras, surgical microscopes that can be magnified 5 times 20 times. Methods 2. 1. 2. 1 Latex solution was perfused into cadaveric head artery. The venous system obtantly separated one side of internal carotid artery (ICA) 2cm on the cervical section of the specimen, and placed the thick needle at the tip. The suture of No. 7 operation was double ligated, and the red latex solution was injected with high pressure syringe through needle.
【学位授予单位】：中国医科大学
【学位级别】：硕士
【学位授予年份】：2005
【分类号】：R651;R322

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