眶颧入路的应用解剖

Study on applied anatomy of the orbitozygomatic approach

目的对眶颧入路进行解剖学研究,为临床手术提供理论依据。方法6例福尔马林固定的湿性成人尸头标本和4例干性头颅标本,模仿眶颧入路并进行观察和分析。结果眶颧入路是在翼点入路基础上游离部分眶顶、眶外侧壁、颧骨和颧弓。颧弓前部和后部的宽度为(21.06±1.65)mm和(7.47±1.72)mm。眶上孔距中线的距离为(23.78±3.02)mm。结论眶颧入路减少了脑组织的牵拉,增加了手术的角度和操作空间。对颅底解剖知识的熟悉,关键孔的位置是该入路的关键。

Objective To study anatomy of orbitozygomatic（OZ）approach and provide a theory for clinical operation.Methods The OZ approach was simulated,observed and analyzed in six cases of adult cadaveric specimens fixed by formalin and four cases of dry skull specimens.Results Based on pterional approach,a series of bone including the roof and lateral wall of the orbit,the lateral surface of zygoma and zygomatic arch were removed with OZ approach.The widths of anterior part and posterior part of zygomatic arch were（21.06±1.65）mm aod（7.47±1.72）mm.The distance between the supraorbital foramen and the median line was（23.78±3.02）mm.Conclusion OZ craniotomy minimizes brain retraction and improves operative angles and working space.A thorough knowledge of cranial base anatomy and placement of the MacCarty keyhole is critical to master OZ approach.