改良额颞颧入路暴露Willis环及其主要分支的显微解剖学研究

Microanatomy research on modified frontotemporal zygomatic approach exposure to Willis circle and its Mainly Branch

目的利用改良额颞颧弓(FTZ)开颅,结合深部骨质切除对Willis环及其主要分支显露进行显微解剖学研究。方法利用10例尸头标本行10侧FTZ开颅,借助显微磨钻,在手术显微镜下切除前、后床突及部分岩骨等,用于显露Willis环及其主要分支,尤其基底动脉、对侧颈内动脉床突上段、大脑中动脉水平段(M1);同时行10侧标准翼点入路暴露上述结构。结果改良FTZ入路较常规翼点入路可更好暴露Willis环及其主要分支。结论改良FTZ入路可用于处理Willis环及其主要分支的多发动脉瘤,并且是较好的选择。

Objective To research the exposure of Willis Circle and its Mainly Branch in a microscopic anatomy way by Modified Frontotemporal Zygomatic （FTZ） craniotomy and combined with deep osteotomies. Methods FTZ eraniotomies were performed on 20 sides of 10 cadaverie heads specimens, with the help of micro-grinding drill and surgical microscope, The anterior posterior clinoidectomies and part of petrosaetc were removed to expose Willis Circle and its Mainly Branch, especially the basilar artery, contralateral supraclinoid segment of internal carotid artery and horizontal section of middle cerebral artery （M1 ） ;Simultaneously, standard pterional craniotomies were performed on 20 sides of these cadaveric heads specimens. Results FTZ approach could better expose Willis Circle and its Mainly Branch , especially the basilar artery, contralateral supraelinoid segment of internal carotid artery and horizontal section of middle cerebral artery （ M1 ） compared to the standard pterion approach. Conclusion FTZ approach can be used to deal with the multiple aneurysms located in Willis Circle and its Mainly Branch compared to the standard pterional approach, and the craniotomy is an alternative to the classical pterional approach maybe.