内镜经鼻入路至岩斜区的解剖研究及Meckel腔的应用解剖研究
发布时间：2018-10-24 17:40
【摘要】：1.内镜经鼻-蝶入路至颅底及岩斜区的解剖研究：目的了解经鼻-蝶入路到达中后颅窝及岩斜区的一些解剖标志和它们的相对关系方法4例8侧甲醛固定后的完整成人尸头标本固定于特制三钉头架，将神经内镜插入鼻腔，模拟经鼻入路到达岩斜区手术结果测量到同侧鼻孔从鼻小柱测量到Meckle腔距离73.1mm±2.67mm，角度12.65±2.16°；对侧鼻孔从鼻小柱测量到Meckle腔距离77.9mm±3.4mm，角度18.8±0.8°同侧鼻孔从鼻小柱测量到颈内动脉海绵窦段前曲段距离75.8mm±3.19mm，，前曲段与中线结构的距离9.1mm±1.2mm结论岩斜区有众多解剖标志及重要的结构如颈内动脉等，了解及熟悉该区域的显微解剖对手术成功与否至关重要 2. Meckel腔的应用解剖研究：目的详细的了解Meckel腔及其毗邻结构的三维关系方法成人4例（8侧）完整经10%formalin固定后头颅湿标本分别逐一从眉弓上约0.5cm处连线到枕外粗隆正上方1.5cm钻孔后用线锯锯开颅顶盖骨，从靠近大脑脚位置切除整个端脑及间脑部分并移除颅骨腔内，使两侧之三叉神经和它的分支（V1V1V3） Meckel腔等得以显露，颅底置于显微镜下放大后观察同时测量记录毗邻相关结构的形态大小和距离结果三叉神经孔的高度我们的结果平均是3.08mm±1.29mm，长度我们的结果平均是7.64mm±1.35mm，我们的研究发现三叉神经孔位于内听道内上约9.82mm±1.51mm，三叉神经孔在外展神经外上方距Dorello管开口9.5mm±0.98mm，三叉神经孔距离岩骨弓状隆起约16.37mm±1.43mm,距离三叉神经感觉根和运动根由脑干发出处11.30mm±1.86mm，距滑车神经与小脑幕边缘相交处约5.32mm±1.33mm结论Meckel腔和周围重要的毗邻结构的三维空间关系及显微解剖架构知识是颅底病变手术成功实施的核心知识
[Abstract]:1. Anatomical study of endoscopic transsphenoidal approach to skull base and petroclival region: objective to understand some anatomic markers of transsphenoidal approach to the middle posterior cranial fossa and petroclival region and their relative relationship. The adult cadaveric head is fixed on a special triple-nailed head frame. The nerve endoscopy was inserted into the nasal cavity, and the results of simulated transnasal approach to the petroclival region showed that the distance from the column of the nose to the Meckle cavity was 73.1mm 卤2.67 mm, and the angle was 12.65 卤2.16 掳. The distance between the contralateral nostril and the Meckle cavity is 77.9mm 卤3.4 mm, the angle is 18.8 卤0.8 掳from the nasal column to the anterior curvature of the cavernous sinus segment of the internal carotid artery, and the distance between the anterior convoluted segment and the midline structure 9.1mm 卤1.2mm conclusion there are many anatomical markers and weight in the diagonal region. The desired structure, such as the internal carotid artery, Understanding and familiarizing the microanatomy of the area is essential to the success of the operation. Applied Anatomical study of Meckel cavity: objective to understand the three-dimensional relationship between Meckel cavity and its adjacent structures in detail methods four adult cases (8 sides) of head wet specimens fixed by 10%formalin were respectively connected to the extraoccipital protuberance from about 0.5cm above the eyebrow arch one by one. 1.5cm was used to saw the cranio-parietal bone with a wire saw. The entire endencephalon and diencephalon were removed from the near foot of the brain and the cranial cavity was removed so that the bilateral trigeminal nerve and its branch (V1V1V3) Meckel cavity were exposed. The skull base was magnified under a microscope, and the size and distance of the adjacent structures were measured simultaneously. The height of the trigeminal foramen was 3.08mm 卤1.29 mm on average, and the average length of our results was 7.64mm 卤1.35 mm. Our study found that the average height of the trigeminal foramen was 1.35 mm. The trigeminal foramen is located about 9.82mm 卤1.51 mm above the internal auditory canal, 9.5mm 卤0.98 mm above the Dorello canal, 16.37mm 卤1.43 mm from the arcuate protuberance of the petrosal bone, 11.30mm 卤1.86 mm from the sensory root and motor root of the trigeminal nerve from the brainstem, and a distance between the trigeminal nerve foramen and the opening of the Dorello canal, and the distance between the trigeminal foramen and the arcuate protuberance of the petrosal bone. About 5.32mm 卤1.33mm at the intersection of the cerebellar tentorium and the motor nerves conclusion the knowledge of the three-dimensional spatial relationship between the Meckel cavity and the important adjacent structures around the cerebellum and the knowledge of the microanatomical structure are the core knowledge of the successful operation of the skull base disease.
【学位授予单位】：第四军医大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R739.4
本文编号：2292083
[Abstract]:1. Anatomical study of endoscopic transsphenoidal approach to skull base and petroclival region: objective to understand some anatomic markers of transsphenoidal approach to the middle posterior cranial fossa and petroclival region and their relative relationship. The adult cadaveric head is fixed on a special triple-nailed head frame. The nerve endoscopy was inserted into the nasal cavity, and the results of simulated transnasal approach to the petroclival region showed that the distance from the column of the nose to the Meckle cavity was 73.1mm 卤2.67 mm, and the angle was 12.65 卤2.16 掳. The distance between the contralateral nostril and the Meckle cavity is 77.9mm 卤3.4 mm, the angle is 18.8 卤0.8 掳from the nasal column to the anterior curvature of the cavernous sinus segment of the internal carotid artery, and the distance between the anterior convoluted segment and the midline structure 9.1mm 卤1.2mm conclusion there are many anatomical markers and weight in the diagonal region. The desired structure, such as the internal carotid artery, Understanding and familiarizing the microanatomy of the area is essential to the success of the operation. Applied Anatomical study of Meckel cavity: objective to understand the three-dimensional relationship between Meckel cavity and its adjacent structures in detail methods four adult cases (8 sides) of head wet specimens fixed by 10%formalin were respectively connected to the extraoccipital protuberance from about 0.5cm above the eyebrow arch one by one. 1.5cm was used to saw the cranio-parietal bone with a wire saw. The entire endencephalon and diencephalon were removed from the near foot of the brain and the cranial cavity was removed so that the bilateral trigeminal nerve and its branch (V1V1V3) Meckel cavity were exposed. The skull base was magnified under a microscope, and the size and distance of the adjacent structures were measured simultaneously. The height of the trigeminal foramen was 3.08mm 卤1.29 mm on average, and the average length of our results was 7.64mm 卤1.35 mm. Our study found that the average height of the trigeminal foramen was 1.35 mm. The trigeminal foramen is located about 9.82mm 卤1.51 mm above the internal auditory canal, 9.5mm 卤0.98 mm above the Dorello canal, 16.37mm 卤1.43 mm from the arcuate protuberance of the petrosal bone, 11.30mm 卤1.86 mm from the sensory root and motor root of the trigeminal nerve from the brainstem, and a distance between the trigeminal nerve foramen and the opening of the Dorello canal, and the distance between the trigeminal foramen and the arcuate protuberance of the petrosal bone. About 5.32mm 卤1.33mm at the intersection of the cerebellar tentorium and the motor nerves conclusion the knowledge of the three-dimensional spatial relationship between the Meckel cavity and the important adjacent structures around the cerebellum and the knowledge of the microanatomical structure are the core knowledge of the successful operation of the skull base disease.
【学位授予单位】：第四军医大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R739.4
【参考文献】
相关期刊论文 前1条
1 张秋航;孔锋;严波;倪志立;;经鼻内镜斜坡脊索瘤和脊索肉瘤的外科治疗[J];中国微侵袭神经外科杂志;2006年10期
本文编号：2292083
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