经口咽入路行枕骨大孔扩大术的解剖学研究

发布时间：2018-03-31 01:33

本文选题：经口咽入路　切入点：枕骨大孔扩大术　出处：《中南大学》2010年硕士论文

【摘要】： 目的：通过对枕骨斜坡骨性结构及周围毗邻关系的解剖学测量,为经口咽入路行枕骨大孔扩大术提供详尽的解剖学依据。方法：1、选取成人干燥颅骨标本40具,10具为正中矢状剖面,30具为水平剖面。分别测量以下内容：斜坡颅底内面、颅底外面的长度；斜坡咽结节处宽度、斜坡最小厚度、中部厚度和最大厚度；斜坡与水平面的夹角；颈动脉管外口内缘、颈静脉孔内外口内缘、破裂孔内外口内缘、舌下神经内外口内缘、寰枕关节内缘与斜坡中线的距离。2、选取完整头颈部标本20具,15具行正中矢状切面,5具行水平切面,分别进行解剖,观察斜坡与周围血管神经的毗邻关系。结果：1、斜坡颅底内面长40.1±2.5mm,斜坡颅底外面长28.2±3.1mm,斜坡中部宽度18.8±2.5mm,斜坡最小厚度6.8±2.3mm,斜坡中部厚度9.8±2.2mm,斜坡最大厚度11.5±1.7mm,咽结节至枕骨大孔前缘距离12.8±1.5mm。2、斜坡与水平面的夹角46.8±4.5°。3、颈动脉管外口内缘距离斜坡中线26.1±3.1mm,颈静脉孔内口内缘距离斜坡中线21.8±2.5mm,颈静脉孔外口内缘距离斜坡中线25.1±2.7mm,破裂孔内口内缘距离斜坡中线10.5±2.9mm,破裂孔外口内缘距离斜坡中线11.8±2.5mm,舌下神经管内口内缘距离斜坡中线13.8±2.3mm,舌下神经管外口内缘距离斜坡中线21.1±2.3mm,寰枕关节内缘距离斜坡中线10.5±2.3mm。4、斜坡上部距离后方基底动脉7.6±1.0mm,距离后方脑桥8.3±1.2mm,斜坡中部距离后方延髓脑桥沟13.5±1.7mm,斜坡下部距离后方延髓6.5±0.8mm。5、斜坡上部与后方硬脑膜之间间隙为1.8±0.2mm,斜坡中部与后方硬脑膜之间间隙为1.3±0.1mm,斜坡下部与后方硬脑、脊膜之间间隙为1.3±0.1mm。6、枕骨大孔前缘距离椎-基底动脉汇合处15.7±2.5mm。7、两侧椎动脉呈基本对称的“人”字形汇合成基底动脉,椎动脉在枕骨大孔水平距离中线4.5±0.9mm,在枕骨大孔上方0.5cm水平距离中线3.2±0.7mm,在枕骨大孔上方1cm水平距离中线2.5±0.8mm,在枕骨大孔上方1.5cm水平距离中线1.5±0.8mm。8、在斜坡开骨窗的宽度为15mm,高度为10mm,深度为6mm,可以满足经口咽入路枕骨大孔扩大术的要求,并有可靠的安全性。结论：本研究通过对枕骨斜坡骨性结构及周围毗邻关系的测量与观察,为临床行经口咽入路枕骨大孔扩大术提供了一定的解剖学依据。
[Abstract]:Objective: to provide anatomic basis for occipital foramen enlargement via oropharyngeal approach by anatomical measurement of the osseous structure of the occipital Clivus and its adjacent relationship.Methods: one, 40 adult dry skull specimens were selected. 10 of them were median sagittal profile and 30 were horizontal sections.The following contents were measured respectively: the internal surface of the slope skull base, the length of the skull base outside, the width of the Clivus pharynx nodule, the minimum thickness of the slope, the middle thickness and the maximum thickness, the angle between the slope and the horizontal plane, the inner margin of the external orifice of the carotid artery,The internal margin of internal and external orifice of jugular foramen, the inner margin of internal and external orifice of ruptured foramen, the inner margin of hypoglossal nerve and the distance between the inner margin of atlanto-occipital joint and the middle line of Clivus.To observe the relationship between Clivus and peripheral blood vessels and nerves.Results the mean length of the skull base of the slope was 40.1 卤2.5mm, the outer length of the base of the slope was 28.2 卤3.1mm, the width of the middle slope was 18.8 卤2.5mm, the minimum thickness of the slope was 6.8 卤2.3 mm, the thickness of the middle slope was 9.8 卤2.2 mm, the maximum thickness of the slope was 11.5 卤1.7 mm, the distance between the pharyngeal nodule and the anterior margin of the foramen magnum of the occipital bone was 12.8 卤1.5 mm 路2, and the angle between the slope and the horizontal plane was 46.8 卤4.5 掳路3.The inner edge of the external orifice of the carotid artery is 26.1 卤3.1 mm away from the middle line of the slope, the inner edge of the internal orifice of the jugular foramen is 21.8 卤2.5 mm from the middle line of the slope, the inner edge of the external orifice of the jugular foramen is 25.1 卤2.7 mm from the middle line of the slope, the inner edge of the internal orifice of the ruptured hole is 10.5 卤2.9 mm from the middle line of the slope, and the inner edge of the external orifice of the ruptured hole isThe distance from the middle part to the posterior medullary pons sulcus was 13.5 卤1.7 mm, the distance from the lower part of the Clivus to the posterior medulla was 6.5 卤0.8 mm 路5, the space between the upper Clivus and the posterior dura mater was 1.8 卤0.2 mm, the gap between the middle Clivus and the posterior dura was 1.3 卤0.1 mm, and the distance between the lower Clivus and the posterior dura was 1.3 卤0.1 mm.The space between meninges was 1.3 卤0.1mm 路6, and the distance between foramen magnum and basilar artery was 15.7 卤2.5mm.The vertebral artery is 4.5 卤0.9mm above the foramen magnum, 3.2 卤0.7mm above the foramen magnum, 2.5 卤0.8mm above the foramen magnum, 1.5 卤0.8mm above the foramen magnum, 1.5 卤0.8mm.8.15mm in height, 10mm in height, and 6mm in depth can meet the requirements of transoropharyngeal approach for the enlargement of the foramen magnum of the occipital bone.And have reliable safety.Conclusion: this study provides anatomic basis for clinical operation of occipital foramen magnum through oropharynx approach by measuring and observing the structure of occipital Clivus and its adjacent relationship.
【学位授予单位】：中南大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R651.1;R322

【参考文献】