扩大经鼻—翼腭窝—翼管至Meckel腔入路的应用显微解剖研究

发布时间：2018-09-02 08:08

【摘要】： 目的：通过对模拟扩大经鼻-翼腭窝-翼管-Meckel腔入路所涉及结构及毗邻结构的显微解剖学研究,分析对侵及Meckel腔及翼管等结构的三叉神经鞘瘤等疾病术中入路的可行、可选性以及该手术入路的利弊。为提高经鼻-翼腭窝入路切除鞍旁肿瘤的手术成功率和安全性提供解剖学依据。方法：对15具成年国人尸体头颅标本进行模拟鼻内镜下沿入路分层显微解剖,对相关解剖标志进行了观察、分析、拍摄和测量。 结果：该入路分三步：进入上颌窦、进入翼腭窝、进入Meckel腔。寻找蝶腭孔沿翼管追踪翼管神经血管束,解剖分离四方形空间(内侧为斜坡旁颈内动脉,外侧为上颌神经,上界是外展神经,下界为颈内动脉岩部)可安全到达Meckel腔。鼻小柱至上颌窦口、蝶腭孔、翼管前孔距离分别为(44.08±2.61)mm、(64.83±2.42)mm、(70.43±2.94)mm；鼻小柱至上颌窦口及蝶腭孔连线与腭骨水平板夹角分别为：(38.10±2.46)°、(26.15±2.26)°；蝶腭动脉外径为2.06±0.41(1.91-2.21)mm.翼管动脉外径为1.10±0.33(0.98-1.23)mm；经蝶鞍旁神经血管关系由前向后分为：视柱三角(OST)、上三角区(STA)、上四边形区(SQA)、下四边形区(IQA)。 结论：扩大经鼻-翼腭窝-翼管-Meckel腔入路提供到达翼管及Meckel腔的前下内面的安全直接入路,对处理翼管及Meckel腔病变是一种可被选择的入路方式。
[Abstract]:Objective: To analyze the feasibility, selectivity, advantages and disadvantages of the approach for resection of the sella via the nasal-pterygopalatine fossa-pterygopalatine canal-Meckel approach in the treatment of trigeminal neurilemmoma involving the structures of the nasal-pterygopalatine fossa and pterygopalatine canal. Methods: Fifteen adult Chinese cadaveric head specimens were dissected under the simulated nasal endoscope along the approach, and the related anatomical markers were observed, analyzed, photographed and measured.
Results: The approach was divided into three steps: into the maxillary sinus, pterygopalatine fossa, and into the Meckel cavity. The distances of maxillary ostium, sphenopalatine foramen and pterygoid foramen were (44.08 (+ 2.61) mm, (64.83 (+ 2.42) mm, (70.43 (+ 2.94) mm, respectively; the angles between nasal columella and maxillary ostium, sphenopalatine foramen and palatal horizontal plate were (38.10 (+ 2.46), (26.15 (+ 2.26)degrees; the external diameter of sphenopalatine artery was 2.06 (+ 0.41) (1.91 - 2.21) mm. Mm. The parasellar nerve-vessel relationship can be divided from anterior to posterior: optic column triangle (OST), upper triangle (STA), upper quadrilateral area (SQA) and lower quadrilateral area (IQA).
Conclusion: Enlarged transnasal-pterygopalatine fossa-pterygoid canal-Meckel approach provides a safe direct approach to the anterior and inferior interior of the pterygoid canal and Meckel cavity, which is an alternative approach for the treatment of pterygoid canal and Meckel cavity lesions.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R322.8

【参考文献】

相关期刊论文 前10条

1 许庚;李源;史剑波;谢民强;刘贤;张革化;徐睿;;经鼻内窥镜颅底手术的探讨[J];耳鼻咽喉头颈外科;1998年04期

2 白娟;尹金淑;彭洪;高顺禹;彭振兴;;翼管在内镜经鼻颅底手术中的标志作用[J];中国耳鼻咽喉头颈外科;2008年11期

3 张秋航,郭永清,杨占泉,卜国铉;经鼻内窥镜手术在颅底外科的应用[J];临床耳鼻咽喉科杂志;1998年03期

4 杨卫忠,陈阵,何曦,倪天瑞,张国良,刘才兴,石松生,陈建屏;显微手术治疗巨大哑铃型三叉神经鞘瘤[J];中国耳鼻咽喉颅底外科杂志;1999年01期

5 许庚,彭蔼璇;经鼻内窥镜前颅底进路切除脑膜瘤一例[J];中华耳鼻咽喉科杂志;1996年01期

6 徐淑军,李新钢,周茂德,陈腾,王磊,冯铭,李蓉辉;三叉神经鞘瘤的手术入路探讨[J];中华神经外科杂志;2005年09期

7 黄学才;徐蔚;江基尧;;选择性超深低温断血流复苏促进猴脑中神经生长因子和胶质细胞源性神经营养因子的表达(英文)[J];Neuroscience Bulletin;2008年03期

8 傅兵;赵继宗;于兰冰;;超声技术在脑动静脉畸形中的应用(英文)[J];Neuroscience Bulletin;2008年06期

9 孙敬武,罗其中,刘认华,叶非常;经鼻内窥镜颅底手术[J];中国微侵袭神经外科杂志;2000年03期

10 毛青,王国强,杨亚英,包颜明;Meckel腔的解剖与影像学表现[J];中国医学影像技术;2005年01期

，

本文编号：2218768