经口入路颅颈交界区腹侧病变的应用解剖研究

Applied anatomy of transoral approach to the lesion of ventral craniocervical junction

目的为经口入路处理斜坡至上颈椎病变提供解剖学依据。方法在30例经动脉灌注红色乳胶的尸头上模拟经口入路手术过程,逐层解剖至延髓和上颈髓,观察并测量双侧椎动脉、基底动脉和脑神经等结构的相关解剖数据。结果经口入路手术可以达到斜坡下缘至C3椎体上缘。双侧椎动脉到中线的距离C1,2为19.7mm,C2,3为15.9mm。结论经口入路手术在处理下斜坡到上颈段病变中具有手术径路短,显露好,创伤小等优点。

Objective To provide anatomical basis for transoral approach (TOA) in dealing with the lesions of craniocervical junction. Methods The TOA were performed in 30 cadaver specimens filled with red silicon in the arteries, followed by dissecting to the medulla and the upper cervical cord. The related anatomical structures such as vertebral artery, basal artery and the cranial nerves were observed and measured. Results The operative exposure in TOA ranged from inferior part of the clivus to the superior part of the C3 vertebral body. The distance from the vertebral artery to the midline: 19.7mm at the level of C1,2, 15.9mm at the level of C2,3. The layers and structures in this area were described in detail. Conclusion The study reveals that the TOA had advantages of short distance, well exposure and little damage in dealing with lesions from the upper cervical to the lower clivus.