经眶颧-海绵窦入路夹闭基底动脉瘤的应用解剖研究

Applied anatomy of orbitozygomatic-cavernous sinus approach to clip the basilar artery aneurysm

目的探讨在经眶颧-海绵窦入路手术中增加基底动脉上段显露的方法。方法在10例标本上模拟经眶颧-海绵窦入路,观察磨除前、后床突后对基底动脉上段的显露情况。结果磨除前床突后形成的间隙为床突间隙;前床突下颈内动脉与动眼神经间的膜为颈内动脉动眼神经膜,沿此膜可进入海绵窦;磨除后床突后,暴露鞍背、上斜坡,即可显露基底动脉上段。结论在经眶颧-海绵窦入路手术中磨除前床突和后床突,可增加对基底动脉上段的显露。

Objective To explore the methods for adding the exposure of superior segment of basilar artery via orbitozygomatic-cavemous sinus approach. Methods Orbitozygomatic-cavemous sinus approach was simulated on 10 cadaveric heads, and the exposure of superior segment of basilar artery observed. Results With orbitozygomatic approach, drilling the anterior clinoid process got a space called the clinoid space （CS）. The membrane between the internal carotid artery beneath the anterior clinoid process and the oculomotor nerve （OMN） is called carotidoculomotor membrane, Along the membrane, the cavernous sinus can be reached. After drilling the posterior elinoid process, exposing the dorsum sellae and the upper clivus, the superior segment of the basilar artery can be exposed, Conclusion By drilling the anterior and posterior clinoid process in the orbitozygomatic-cavernous sinus approach, the exposure of superior segment of the basilar artery can be increased.