颞下窝A型入路的显微解剖学及临床应用研究

发布时间：2018-01-19 08:46

本文关键词： 颞下窝A型入路侧颅底颞下窝颈静脉孔显微解剖　出处：《天津医科大学》2009年硕士论文　论文类型：学位论文

【摘要】： 目的: 颞下窝A型入路涉及的解剖结构复杂,而与此入路相关的国人解剖学研究报道少见。本研究通过观察颅骨标本颈静脉孔及周围重要结构和在尸头标本上模拟颞下窝A型入路,获得相关的国人解剖学数据,为临床应用提供参考。方法: 应用10例国人颅骨测量颈静脉孔大小及与周围重要结构间距离;应用10例国人尸头标本对颞下窝A型入路的相关结构进行显微解剖研究和测量。结果: 1.颈静脉孔外口距茎突根[(4.17±1.99)(1.16～8.32)]mm、距茎乳孔[(6.06±1.71)(3.22～9.08)]mm、距舌下神经管[(2.41±1.23)(0.66～4.54)]mm。2.面神经鼓室段长度[(9.66±1.41)(7.68～12.36)]mm、乳突段长度[(16.08±2.15)(13.26～21.56)]mm、面神经锥段距外半规管[(1.08±0.41,)(0.46～2.26)]mm。3.颈静脉球距面神经乳突段[(6.56±1.81)(3.12～9.28)]mm、距后半规管弓峰下缘[(3.67±1.27)(1.76～6.58)]mm,颈静脉球高出下鼓室者1例。4.岩骨内颈内动脉垂直段长度[(10.36±2.31)(5.52～14.28)]mm、水平段长度[(19.41±2.02)(15.22～23.86)]mm。5.后半规管弓峰下缘距寰椎横突[(31.22±1.93)(27.86～35.14)]mm、乙状窦垂直臂距下颌关节[(19.17±1.51)(16.58～21.66)]mm、乳突尖距岩尖[(53.91±4.82)(49.92～63.32]mm。结论: 颞下窝A型入路可广泛的暴露颞下窝后部及迷路下区特别是颈静脉孔区的病变又避免开颅损伤脑组织,适用于切除迷路下区的病变,尤其适合切除颈静脉孔周围且未侵入硬膜的各种类型肿瘤,该入路也可与其它多种颅内进路手术联合进行颅内外交通肿瘤的切除。此手术入路相关数据的测量结果,有助于术中定位重要结构,提高肿瘤切除率,减少术后并发症的发生。
[Abstract]:Objective: Type A approach to infratemporal fossa involves complex anatomical structures. This study was conducted by observing the important structures of the jugular foramen and surrounding cranial specimens and simulating the type A approach of the infratemporal fossa on the cadaveric head. To obtain relevant anatomical data of Chinese people and provide reference for clinical application. Methods: The size of the jugular foramen and the distance between the jugular foramen and the surrounding important structures were measured in 10 Chinese cranial bones, and the related structures of the type A approach in the infratemporal fossa of 10 Chinese cadaveric heads were studied and measured. Results: 1. External orifice of jugular foramen to the root of styloid process [4.17 卤1.99 卤1.16 卤8.32) mm from stem mammary foramen. [6.06 卤1.71 卤3.229.08) mm from the hypoglossal canal. [The length of tympanic segment of facial nerve was 2.41 卤1.23 (0.66 卤4.54)] mm.2. [9.66 卤1.41 m, 7.68 卤12.36) mm, mastoid segment length. [(16.08 卤2.15 ~ 13.26 卤21.56) mm, facial nerve cone distance from external semicircular canal. [0.46 卤2.26)] mm.3.The distance from the jugular bulb to the mastoid segment of the facial nerve. [6.56 卤1.81 m from the lower edge of the posterior semicircular canal peak. [3.67 卤1.27 ~ 1.76 ~ 6.58) mm, the jugular bulb was higher than the hypotympanum in 1 case .4.The length of the vertical segment of the internal petrosal internal carotid artery. [10.36 卤2.31 卤5.52 卤14.28) mm, horizontal length. [The posterior semicircular canal is located at the lower edge of the arch peak from the transverse process of atlas. [31. 22 卤1. 93 卤27. 86 ~ 35. 14) mm, vertical arm of sigmoid sinus to mandibular joint. [19. 17 卤1. 51 + 16. 58 卤21. 66) mm, mastoid tip to rock tip. [53.91 卤4.82 ~ 49.92 ~ 63.32] mm. Conclusion: The type A approach of infratemporal fossa can extensively expose the lesions in the posterior part of the infratemporal fossa and the sublabyrinthine region, especially in the foramen jugular region, and avoid craniotomy, which is suitable for removing the lesions in the sublabyrinthine area. Especially suitable for removing various types of tumors around the jugular foramen and without invasion of the dura. This approach can also be combined with many other intracranial approaches for resection of extracranial and extracranial communicating tumors. The results of the relevant data of the surgical approach are helpful to locate important structures during the operation and to improve the resection rate of the tumors. The incidence of postoperative complications was reduced.
【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2009
【分类号】：R322

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