内镜与显微镜下Heubner返动脉的应用解剖

Applied anatomy of the recurrent artery of Heubner under endoscope and microscope

目的研究经眶上锁孔入路对国人Heubner返动脉(RAH)的内镜与显微镜下解剖。方法对11具(22侧)标本模拟眶上锁孔入路对RAH行显微镜下与内镜下解剖,观察并测量其走行、长度、管径及分支等。结果共见RAH31支,每侧1￣3支;RA H起始点多见于大脑前动脉(ACA)的前交通动脉(ACoA)分叉2m m范围内;起始部常与A CAA1段平行伴行,多呈袢状走行于A1的上方或前方;其管径及走行方向发生变异时易被误认为ACA。结论经眶上锁孔入路可观察到RAH,其出现恒定,但起源处、管径、数目及走行可有变异。内镜下更有利于观察。临床上从ACA下后壁解剖可减少损伤RAH。

Objective To study more detailed microscopic and endoscopic anatomic data of the recurrent artery of Heubner (RAH) via a supraorbital keyhole approach. Method Eleven latex-injected adult cadaveric heads (22 sides) were anatomized under microscope and endoscope via supraorbital keyhole approach and the running, length, diameter and branches of RAH measured. Results Thirty-one RAHs (1-3 branches each side) were found. Most of them arose from the anterior cerebral artery (ACA) at anterior communicating arterial level within 2 mm and coursed superior or anterior to the ACA. The RAH with anatomical variations may be mistaken as ACA. Conclusion RAH can be observed via a supraorbital keyhole approach. RAHs showed constant appearance with some anatomical variations of their origin, diameter, number and pathway. Observation by endoscope is instructive. Dissection should be started from the posterior inferior part of ACA to avoid the injury to the RAH.