前床突的应用解剖学研究

Applied anatomy of the anterior clinoid process

目的为颅底外科提供前床突的解剖学资料。方法取164例(328侧)成人干颅骨和30例(60侧)成人尸头标本,观察和测量前床突及其邻近结构,在形态学上对其进行分类,观察其变异情况。结果国人前床突的外形可分为三边型、四边型、五边型、乳头型、J-型、手指型,其中以三边型最为多见。前床突内侧缘可呈钝角、直角、锐角和弧形。前床突与中床突、后床突可形成骨桥或通过韧带连接。气化前床突占11.7%,气腔可与蝶窦、筛窦相通。结论前床突及其周围结构复杂,且国人前床突具有高度变异性。处理该区域病变术前需行充分影像学检查,了解前床突气化情况;术前、术中密切关注骨桥变异情况。

Objective To provide microanatomical data of the anterior clinoid process （ACP） for the skull base surgery. Methods One hundred and sixty-four dry adult skulls （328 sides） and 30 cadaveric heads （60 sides） were observed and measured for microanatomical data of ACP and its adjacent structures. The ACPs and their adjacent structures were classified according to morphology to understand their variations. Results The ACP can be classified into triangular, quadrilateral, pentagonal, nipple, J and finger shapes in Chinese. Triangular type of the ACP was the most common type. Medial margin of the ACP could be obtuse, right, or acute angles and arc shape. Bone bridge and ligament could be found between the ACP and both middle and posterior clinoid processes. ACP pneumatization was found in 11.7% of all sides, and the air space might communicate with the sphenoid sinus and ethmoid sinus. Conclusion The ACP and its adjacent structures are very complex, and ACPs of Chinese skulls are highly variable. Preoperative imaging examination is necessary to evaluate pneumatization of the ACP. Variations of the bone bridge should be kept in mind before and during the operation.