枕下远外侧入路的显微解剖及临床应用

Microsurgical anatomy and clinical study of the far lateral suboccipital approach

目的:研究枕下远外侧入路的显微解剖,并用以指导临床工作。方法:对14具甲醛固定的成人湿性头颅标本进行枕下远外侧入路的显微解剖,并对12例下斜坡及枕骨大孔前方脑干腹侧肿瘤患者进行手术切除。结果:寰椎横突及枕下三角是枕下远外侧入路中的重要解剖标志,磨除枕髁、颈静脉结节能增加术野的暴露。本组12例肿瘤患者中全切除9例,次全切除3例,无手术死亡。结论:研究枕下远外侧入路的显微解剖,有助于安全切除下斜坡和枕骨大孔腹侧肿瘤。

Objective：To investigate the microsurgical anatomy of the far lateral suboccipital approach and to evaluate its application to surgical approach. Methods：Fourteen cadaveric heads （28 sides ） were dissected through far lateral suboccipital approach to obtain the anatomical data of this approach . A retrospective analysis of microsurgical treatment in 12 cases of tumors situated at lower clivus and foramen magnum was performed . Results ： Transverse process of C1 and inferior occipital trangle were important anatomical marks in the far lateral occipital approach . Drilling the condyle and jugular tubercle was benefit to expand the surgical space. Total removal of the turmors was achieved in 9 patients, subtotal removal in 3 patients , and without any surgical morbidity. Conclusion：Study on the microsurgical anatomy of the far lateral suboccipital approach was helpful in resecting tumors situated at lower clivus and foramen magnum.