成人侧颅底临床解剖学研究

Clinical anatomical study of the adult lateral skull base

目的：通过对侧颅底重要解剖标志的观察与测量，为临床侧颅底手术的定位、导航提供解剖学依据。方法：20具40侧10％甲醛浸泡的成人尸头（黄种人）和20例临床手术患者进行侧颅底指引标志的观察与测量。尸头标本按1～40的顺序进行编号；20侧临床手术患者按1～20的顺序进行编号。结果：通过测量得出侧颅底相关定位标志的解剖数据：颈静脉孔静脉部、神经部与颅底重要指引标志的距离；迷路三角、迷路后三角及乳突表面三角的面积；侧颅底手术中面神经主动移位的最大距离。结论：耳科与颅底外科的手术几乎均在深埋于颅（颞）骨的狭窄空间内操作，周围布满了重要的血管和神经，术者了解侧颅底重要标志的定位测量数据有利于手术中安全扩大手术视野，有效避免术中损伤重要血管、神经，最大限度地保留面神经功能．最终提高患者的生存质量。

Objective：Through the observation and the measurements of the significant anatomical landmark of the lateral skull base, to provide anatomical data of clinical location and navigation for surgery at the lateral skull base. Method：Significant anatomical landmarks of twenty adult cadaveric heads （40 sides） fixed in 10 % formaldehyde and 20 operation cases （20 sides） had been observed and measured. Lateral skull bases of cadaveric heads were numbered from 1 st to 40th, while the operation cases were numbered from 1 st to 20th. Result：The anatomical data was achieved by measureing related anatomical landmark as follows： the distances between the significant landmark of the lateral skull base and the pars neuralis, vein of the jugular foramen; the areas of rautmann trian gle; post labyrinthus triangle and the superficial triangle of processus mastoideus; the maximal distance of initiative displacement of facial nerve in the lateral skull base operations. Conclusion： The data measured at lateral skull base could effectively help operators not only to enlarge the field of vision in operations with security and to avoid the damagement of the important blood vessel and nerves, but also to retain the function of the facial nerve to the utmost,