耳上经岩骨嵴小骨窗入路至岩斜区显微解剖学研究

Microanatomical study of the minicraniotomy up-ear transpetrosal ridge approach to the petroclival region

目的在部分岩斜区侧方入路基础上,对耳上经岩骨嵴小骨窗入路至岩斜区进行显微解剖学研究,力求取得良好显露的同时,使手术入路更加简便、安全、实用,降低创伤,减少并发症。方法10%甲醛固定的国人成人头颅湿标本10例,漂白的颅骨干标本10例,模拟手术操作,对入路涉及重要结构进行观察、测量、拍照。结果在4cm×3cm大小骨窗范围内完成所有手术操作,入路涉及重要解剖结构包括Labbe静脉、岩骨内部结构等,可较好的显露脑干腹侧间隙、岩骨背侧及桥小脑角区。结论耳上经岩骨嵴小骨窗入路,能取得和Kawase入路、乙状窦前入路、部分迷路切除岩骨尖(PLPA)入路等侧方入路相似或相近的显露,具有创伤小、操作简便等优点。

Objective To investigate the feasibility and the microsurgical anatomy of the minicraniotomy up-ear transpetrosal ridge approach to the petroclival region.Make the operation a good exposing with simple,safe,practical and minimal invasive character,reduce postoperative complications.Methods Surgical anatomic study was done on 10 adult cadaver heads fixed in 10% formalin and 10 dry skulls,The relationships of important anatomic structures and positions were observed,measured and photographed.Results A surgical operations were performed within 4 cm×3 cm in window.The important structures include vein of labbe,petrous bone.The structures were exposed of brain stem ventral space,cerebellopontile angle and rock of the dorsal.Conclusion The expose of minicraniotomy up-ear transpetrosal ridge approach is similar with subtemporal anterior transpetrosal approach（Kawase）,partial labyrinthectomy petrous apicectomy approach（PLPA）and transpetrosal presigmoid approach.It allows the operation simple and minimal invasive.