颈静脉孔区哑铃型肿瘤手术入路及相关解剖
发布时间：2019-05-13 22:52
【摘要】：颈静脉孔区(jugular foramen area)是由枕骨和颞骨岩部围成的骨性孔道,位于颞下颌关节、下颌支和颈椎椎体中心,且孔道内神经、动静脉结构及其外侧颅颈交界区的肌肉复杂、显露困难,造成这一区域手术难度及风险很大,一直以来都是神经外科及其他相关科室共同关注的焦点之一。此区域哑铃型肿瘤波及范围较大,常为骑跨于颈静脉孔的颅内外沟通瘤。本综述的目的是在前人对颈静脉孔解剖及手术入路认识的基础上,找到一种适合颅内外沟通哑铃型肿瘤的手术入路,即耳后头颈部“C”形切口,并在尸头上进行解剖,详细阐述颈静脉孔区的重要结构及其之间的相互关系,为临床工作提供依据及获得经验,并了解其优缺点。1充分显露手术视野是保证手术顺利进行的先决条件,耳后头颈部大“C”形切口不仅能对颅内肿瘤进行暴露,对颅外及上颈部术野暴露也令人满意,可较为容易的对哑铃型肿瘤进行一期全切。2颈静脉孔区及颅颈交界区结构复杂,包含众多肌肉组织及神经结构,熟悉并掌握颈这些解剖结构有助于手术顺利完成,提高手术全切率,保护颅神经及周围正常组织,减少术后并发症的发生。
[Abstract]:Jugular foramen (jugular foramen area) is a osseous foramen surrounded by occipital and temporal bone. It is located in the center of TMJ, mandibular branch and cervical vertebrae, and the muscles of internal foramen nerve, arteriovenous structure and lateral cranio-cervical junction are complex. The difficulty of exposure makes the operation difficult and risky in this area, which has always been one of the focuses of neurosurgery and other related departments. Dumbbell tumors in this area have a large coverage and are often intracranial and extracranial communication tumors that span the jugular foramen. The purpose of this review is to find a suitable surgical approach for dumbbell tumors, that is, the "C" incision of the posterior head and neck of the ear, on the basis of the previous understanding of the anatomy of jugular foramen and the surgical approach, and to dissect it on the head of the corpse. This paper expounds in detail the important structure of jugular foramen and the relationship between them, provides the basis for clinical work and obtains experience, and understands its advantages and disadvantages. 1 fully revealing the surgical field of vision is a prerequisite to ensure the smooth progress of the operation. The large "C" incision in the posterior head and neck of the ear can not only expose the intracranial tumors, but also expose the extracranial and upper neck surgical fields. It is easier to perform one-stage complete resection of dumbbell tumors. 2 the structure of jugular foramen and cranio-cervical junction is complex, including many muscle tissues and nerve structures, and familiarity with and mastery of these anatomical structures of neck is helpful to the smooth completion of the operation. Improve the total resection rate, protect the skull nerve and surrounding normal tissue, reduce the occurrence of postoperative complications.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R739.4
本文编号：2476242
[Abstract]:Jugular foramen (jugular foramen area) is a osseous foramen surrounded by occipital and temporal bone. It is located in the center of TMJ, mandibular branch and cervical vertebrae, and the muscles of internal foramen nerve, arteriovenous structure and lateral cranio-cervical junction are complex. The difficulty of exposure makes the operation difficult and risky in this area, which has always been one of the focuses of neurosurgery and other related departments. Dumbbell tumors in this area have a large coverage and are often intracranial and extracranial communication tumors that span the jugular foramen. The purpose of this review is to find a suitable surgical approach for dumbbell tumors, that is, the "C" incision of the posterior head and neck of the ear, on the basis of the previous understanding of the anatomy of jugular foramen and the surgical approach, and to dissect it on the head of the corpse. This paper expounds in detail the important structure of jugular foramen and the relationship between them, provides the basis for clinical work and obtains experience, and understands its advantages and disadvantages. 1 fully revealing the surgical field of vision is a prerequisite to ensure the smooth progress of the operation. The large "C" incision in the posterior head and neck of the ear can not only expose the intracranial tumors, but also expose the extracranial and upper neck surgical fields. It is easier to perform one-stage complete resection of dumbbell tumors. 2 the structure of jugular foramen and cranio-cervical junction is complex, including many muscle tissues and nerve structures, and familiarity with and mastery of these anatomical structures of neck is helpful to the smooth completion of the operation. Improve the total resection rate, protect the skull nerve and surrounding normal tissue, reduce the occurrence of postoperative complications.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R739.4
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