| 摘要: |
| 目的 研究颅神经微血管减压术的枕下乙状窦后入路相关解剖,为临床手术提供解剖学资料。方法 10%甲醛固定并灌注乳胶的中国人成人头颅湿性标本8例,模拟手术入路,逐层解剖、观察桥小脑角区解剖和主要血管神经,重点研究上、中、下神经血管复合体的解剖和毗邻关系。结果 三叉神经入脑干区与乙状窦横窦移行处的距离为(4.4±0.2) cm,面神经出脑干区与乙状窦横窦移行处距离为(4.1±0.2) cm,桥小脑池的宽度为(0.2±0.1) cm,小脑绒球高度为(0.3±0.1) cm。结论 通过经枕下乙状窦后入路,解剖桥小脑角区神经血管,研究骨窗、岩静脉,上、中、下神经血管复合体,充分认识各个重要神经和血管结构毗邻关系,对手术有重要指导意义。 |
| 关键词: 微血管减压 显微解剖 桥小脑角区 |
| DOI： |
| 投稿时间：2013-05-06修订日期：2013-09-13 |
| 基金项目:复旦大学中山医院青年基金(科补216). |
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| Microanatomical study of cranial nerve microvascular decompression |
| XU Wen-long1,ZHU Wei1*,DAI Zheng-shou2 |
(1. Department of Neurosurgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
2. Department of Anatomy, Medical College, Fudan University, Shanghai 200032, China
*Corresponding author.) |
| Abstract: |
| Objective To investigate the suboccipitalretrosigmoid approach-related anatomy for cranial nerve microvascular decompression, so as to provide clinical anatomical data for microvascular decompression. Methods Eight adult cadaveric heads were fixed in 10% formalin and purfused with emulsion, and then were used to simulate the operation approach. Dissections were performed gradually; the anatomy variations and neurovascular travelling, especially the upper/middle/lower neurovascular complex in cerebellopontine angle (CPA) region, were observed and measured. Results The distance between the site of trigeminal nerve going into the brain stem to the meeting point of the transverse and sigmoid sinuses was (4.4±0.2) cm; the distance between facial nerve going out of the brain stem to the meeting point of the transverse and sigmoid sinuses was (4.1±0.2) cm. The distance from midpoint of horizontal fissure of the cerebellum to anterior bone wall (the width of the CPA cistern) was (0.2±0.1) cm and the height of flocculus was (0.3±0.1) cm. Conclusion It is of great significance for clinical surgery to, via the suboccipitalretrosigmoid approach, dissect the neurovascular tissues in CPA, with focus on the relationship between important neural and vascular tissues, including the bone window, petrosal veins, and the upper/middle/lower neurovascular complex. |
| Key words: microvascular decompression microanatomy cerebellopontine angle |
