骨性颈静脉孔区的应用解剖

Microanatomy of the osseous jugular foramen area

目的:观察骨性颈静脉孔区的显微解剖,为临床提供解剖学资料。方法:显微镜下观察20例成人颅骨标本颈静脉孔的位置、组成、形态,并测量其大小及与周围骨性结构的距离。结果:颈静脉孔是由枕骨和颞骨岩部合围的一个骨性管道,85%的外口、75%的内口右侧大于左侧;颈静脉孔内有颞突、枕突、锥形窝、颈静脉窝等结构;内口的前方与岩下窦沟相连,后接乙状窦沟,内口的上方有内耳门和前庭小管外口;颈静脉孔的外侧有茎乳孔和茎突,茎乳孔外接鼓乳裂,后方有枕骨颈突。结论:多数颈静脉孔右侧大于左侧,乙状窦沟前移以右侧多见;鼓乳裂可以定位茎乳孔及颈静脉孔外侧壁;枕骨颈突是确定颈静脉孔后壁的标志。

Objective： To study the osseous jugular foramen （JF）, and the relationship between JF and its adjacent bony structures and to provide the clinical operation with the anatomic knowledge. Methods： The localization, structure, form and size of 40 JF from 20 dry skulls were examined with magnification （ 5〈 3）. The distances between JF and the adjacent bony structures were measured. Results： The JF consisted of the petrosal hone and occipital bone （one on each side）. The right foramen was larger than the left in 75 % intracranially and in 85 % extracranially. There were the temporal process, occipital process, pyramidal fossa and jugular fossa in the JF. Extracranially, the external ostium of the carotid canal and the inferior petroclival fissure were anterior to the JF. The styloid process, the stylomastoid foramen and the papillary process were located lateral to the JF＇. The external ostium of the carotid canal, the styloid process and the papillary process were nearly in a beeline. The external ostium of the hypoglossal canal and the occipital condyles located medial to the JF. The distance from the back of the occipital condyles to the intracranial orifice of the hypoglossal canal was about 8.15 mm. The jugular process of occipital bone was posterior to the jugular foramen. Intracranially, the JF located below the internal acoustic pore and upperlateral to the intracranial orifice of the hypoglossal canal. The external ostium of the vestibular aqueduct located upperlateral to the JF. The jugular tubercle situated medial to the medial edge of the JK Conclusion： The right foramen was larger than the left in most cases. The tympanomastoid notch provides an excellent landmark for locating the stylomastoid foramen and the lateral wall of the JK The jugular process of occipital bone provides a useful landmark for identifying the posterior wall of the JF.