经小脑延髓裂入路手术间隙的应用解剖研究

Applied anatomic research for transcerebellomedullary fissure approach

目的 为经小脑延髓裂入路切除桥脑背侧及第四脑室内占位性病变提供解剖学基础。方法 对经甲醛固定、血管内灌注彩色乳胶的 2 0具国人成人尸头标本 ,应用显微外科解剖技术观察经小脑延髓裂入路相关解剖结构。结果 经小脑延髓裂入路 ,可通过脉络膜、下髓帆及蚓小结到达菱形窝的任何部位 ,通过外侧隐窝到达脑桥和延髓的背外侧。结论 经小脑延髓裂入路通过正常的解剖间隙到达第四脑室和脑干的侧方 ,可减少对脑组织的损伤 ,提高手术疗效。

Objective To provide anatomic base for resecting the tumors of dorsal pons and the fourth ventricle with transscerebellomedullary fissure approach. Methods Twenty Chinese cadaveric heads fixed with formalin and with their arteries and veins perfused with color latex were dissected with microsurgical anatomical skills to observe anatomic structures with transcerebellomedullary fissure approach.Results Via the transcerebellomedullary fissure approach, any part of the rhomboid fossa can be reached by exposing and separating the tela choroida, inferior medullary velum and nodule of vermis. And the dorsolateral part of pons and of medulla obligata can be reached by lateral recess. Conclusion Transcerebellomedullary fissure approach can reach the fourth ventricle and the lateral parts of the brainstem through normal anatomic spaces and reduce the lesions of the vessels and nervous tissure to improve surgical prognosis.