舌咽神经阻滞入路的解剖基础

STUDY ON THE ANATOMICAL BASES FOR BLOCKING GLOSSOPHARYNGEAL NERVE

目的:为舌咽神经阻滞入路和预防并发症的发生提供解剖学资料。方法:应用35具成人头、颈部标本,逐层解剖,显露舌咽神经并追溯到颈静脉孔外口,仔细观察舌咽神经与周围诸结构的位置及毗邻关系并测量相关数据。结果:舌咽神经与迷走神经、副神经、岩下窦及颈内静脉一起自颈静脉孔出颅,出颅后与颈内动脉、颈内静脉、舌下神经、副神经、迷走神经等结构关系密切。舌咽神经阻滞进针的深度即下颌角与外耳门连线的中点至颈静脉孔的距离,左侧为22.33±1.98mm,右侧为22.45±2.03mm,进针方向为斜向内上方稍偏前,与正中矢状面呈45～60°。结论:本研究可为舌咽神经阻滞入路和预防并发症的发生提供可靠的解剖学资料。

Objective：To provide anatomical materials for blocking glossopharyngeal nerve and preventing complications.Methods：35 adult head and neck samples were used in this study.The glossopharyngeal nerve was exposed and ascended to external aperture of the jugular foramen. The adjacent relations between glossopharyngeal nerve and ambient structures were carefully observed, and correlated data were measured.Results： The glossopharyngeal nerve left the cranial cavity through the jugular foramen along with vagus nerve, accessory nerve, inferior petrosal sinus and jugular vein. After it left the cranial cavity, the glossopharyngeal nerve had close relations with internal jugular artery, internal jugular vein, hypoglossal nerve, accessory nerve and vagus nerve. The depth of blocking glossopharyngeal nerve, that was the distance between the jugular foramen and the midpoint of angle of mandible and external acoustic foramen,was 22.33 ±1.98mm on the left and 22.45 ± 2.03mm on the right; the blocking direction was inclined to the medial and superior and slightly anterior, and this direction had a 45 - 60° angle with the median sagittal plane.Conclusions：This study can provide reliable anatomic data for blocking glossopharyngeal nerve and preventing complications.