海绵窦断层解剖研究及其临床意义

Sectional anatomic study of cavernous sinus and its clinical significance

目的在水平、矢状和冠状3个方位上对海绵窦进行断层解剖研究,了解海绵窦断层解剖特点。方法采用低温铣切技术对3例头颅标本进行水平、矢状和冠状位的铣切,利用数码相机获取数字资料,观察海绵窦大小、形态、内部结构和毗邻结构。结果海绵窦及其毗邻结构在断层层面上可清晰显示:(1)海绵窦的外侧壁有两层膜性结构,外层为颅中窝硬脑膜的延续,而内层为动眼神经、滑车神经、三叉神经的分支构成的神经鞘膜。(2)外展神经穿过Dorello管后进入海绵窦内,与颈内动脉毗邻。(3)海绵窦内侧与垂体之间仅仅为疏松的膜性结构,是垂体腺瘤易于侵犯海绵窦的解剖学基础。结论海绵窦断层解剖研究对了解海绵窦断层解剖特点、指导海绵窦影像学诊断以及海绵窦区的手术治疗有指导意义。

Objective To study the features of horizontal, coronal and sagittal sectional anatomy of cavernous sinus （CS） and to explore the complex relationships of the internal and adjacent structures on the base of sectional anatomy. Methods The horizontal, coronal and sagittal sections of CS were obtained by milling technique at a low temperature and the digital images were taken using high-resolution digital camera for observing the size, shape, internal and adjacent structures of CS. Results The indistinct microstructures in isolated images can be clearly identified by the utility of continuous images： （1） The lateral wall of CS was consisted of two membranes： outer membrane was continued from duramater of middle cranial fossa, inner membrane was lamellar sheath of the oculomotor nerve, trochlear nerve and trigcminal nerve. （2）The abducens nerve stayed in CS after traversing Dorello＇ s canal. （3）The thin wall between CS and hypophysis allowed the invasiveness of pituitary adenomas into CS. Conclusion Sectional anatomic study can make us know the morphologic traits of CS, and provide a significant guidance for the imaging diagnosis and the neurosurgical operation of this area.