颞下锁孔入路的显微解剖学研究

发布时间：2018-10-07 17:52

【摘要】：目的进行颞下锁孔入路解剖学结构研究,为临床颞下锁孔入路手术入路提供解剖依据。方法在显微镜下对6例经甲醛固定的国人成人尸头模拟颞下锁孔入路手术进行解剖,测量重要神经血管及其相关结构之间的距离以及观察显露范围和相关解剖关系。结果颧弓至小脑幕缘、脑干和前床突的最短距离分别为41.1±5.1mm、45.6±3.3mm和61.1±7.4mm。颞骨岩部扩大磨除前后显露的Day菱形区面积有显著差异(P0.05)。颞下锁孔入路可清楚的显露海绵窦外侧壁上的各神经血管及三角,鞍侧区可清晰的显露颈内动脉、后交通动脉及其穿支、脉络膜前动脉和垂体柄,磨除颞骨岩尖部可显著增加岩斜区脑干显露。结论颞下锁孔入路对于海绵窦外侧壁,岩斜区及鞍侧区显露效果好,入路简单直接,组织损伤小。
[Abstract]:Objective to study the anatomical structure of subtemporal keyhole approach and to provide anatomic basis for clinical subtemporal keyhole approach. Methods six Chinese cadaveric cadavers who were fixed by formaldehyde were dissected by simulated subtemporal keyhole approach under microscope. The distance between important nerve vessels and their related structures was measured and the exposure range and related anatomical relationship were observed. Results the shortest distance between zygomatic arch and cerebellar tentorial margin, brainstem and anterior clinoid process was 41.1 卤5.1 mm and 61.1 卤7.4 mm respectively. There was significant difference in the area of Day rhombic area before and after enlargement and grinding of temporal bone (P0.05). The subtemporal keyhole approach can clearly expose the nerve vessels and triangles on the lateral wall of the cavernous sinus, and the Sellar region can clearly expose the internal carotid artery, posterior communicating artery and its perforating branches, anterior choroidal artery and pituitary stalk. The petrous apex of temporal bone can significantly increase the exposure of the petroclival brain stem. Conclusion the subtemporal keyhole approach is effective in exposing lateral wall of cavernous sinus, petroclival region and lateral Sellar region, and the approach is simple and direct, with little tissue damage.
【作者单位】：广州军区武汉总医院神经外科;南方医科大学;
【分类号】：R322.81

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