床突间隙的显微解剖学研究

Microsurgical anatomic study of clinoid space

目的 为临床上磨除前床突后形成床突间隙提供显微解剖学数据。方法 在手术显微镜下对10例（20侧）成人尸头的前床突及床突间隙进行显微解剖观测。结果 （1）前床突是锥形骨性结构，其长、宽、厚分别为（9.39±1．23）mm、（12．25±2．40）mm、（5．29±1．21）mm。（2）床突间隙为磨除前床突后形成的锥形空间，间隙基底部上、下、内、外侧边长度分别为（9．32±1．18）mm、（5．32±1．18）mm、（7．70±1．31）mm、（11．18±2．51）mm，间隙高为（10．05±1．40）±。床突间隙可以提供0．8-1．0cm^3的显露空间。（3）颈内动脉床突段位于颈内动脉上、下环之间，直径为（4．23±0．59）mm，长度为（2．84±1．06）mm。（4）前床突气化率为2／20。（5）Ⅱ、Ⅲ、Ⅳ、Ⅴ1、Ⅵ脑神经、颈内动脉床突段、颈内动脉床突上段起始部紧贴前床突走行，其间隔以相应的硬膜层。结论 床突间隙增加了手术操作空间。颈内动脉床突段为海绵窦内结构。形成床突间隙时，注意对前床突毗邻结构的保护。

Objective To provide detailed anatomic data ofclinoid space （CS）. Methods The anterior clinoid process （ACP） and CS of 10 adult cadaver head specimens （20 sides） were observed and measured under operating microscope. Results （1） ACP was a taper structure with its length, width, thickness being （9.39±1.23） mm, （12.25±2.40） mm, （5.29±1.21） mm respectively. （2） CS was a taper lacuna after ACP was stripped. The four lengths of the CS basic margins were （9.32±1.18） mm, （5.32±1.18） mm, （7.70±1.31） mm, （11.18±2.51） mm respectively, and its height was （10.05±1.40） mm. CS could provide about 0.8-1.0 cm^3 additional operating space. （3） Clinoidal internal carotid artery （ICA） was located between distal and proximal dural ring of the ICA; its diameter was （4.23±0.59） mm and length was （2.84±1.06） mm. （4） The rate of gasification in ACP was 2/20. （5） Cranial nerves of II, III, IV, V 1, VI, clinoidal ICA and the initiation of supraclinoid portion of ICA were found nearly sticking to ACP, separated by corresponding cerebral dura mater layer. Conclusion CS could provide a larger operation space ofACP. Clinoidal internal carotid artery was a structure of cavernous sinus. The adjacent structures of ACP should be carefully protected when ACP was pneumatic.