前床突旁区的显微解剖及其临床意义

Microsurgical anatomy and clinical significance of paraclinoid region

目的:为前床突旁区(Paraclinoid Region)病变显微外科手术提供解剖学基础。方法:对15例(30侧)干性颅骨标本的骨性结构直接测量;对15例(30侧)湿性头颅标本在手术显微镜下解剖并测量。结果:①前床突(ACP)的长度为(10.29±0.78)mm,宽度为(9.03±0.71)mm;视柱(OS)的长度为(5.66±0.67)mm,宽度为(5.72±0.73)mm。②床突段颈内动脉(ICA)位于远、近侧硬脑膜环之间,长度为(5.14±0.74)mm。③远侧硬脑膜环厚而坚韧,厚度为(0.52±0.08)mm;近侧硬脑膜环薄而松弛,厚度为(0.22±0.06)mm,呈袖套状被覆于床突段ICA表面,在二者之间可有海绵窦静脉丛突入。④眼动脉直径为(1.78±0.46)mm,93%从远侧硬脑膜环远端发出。结论:①床突段颈内动脉多数情况下应属于海绵窦内结构。②大多数眼动脉起源于床突上段ICA。

Objective： To study anatomic structures of the paraclinoid region,and provide basic data for neurosurgery in this region. Methods： 30 sides of skull specimens from 15 dry skull and 30 sides of cadaveric specimens from 15 adult cadaveric head were dissected, observed and measured under the microscope. Results： ①The length of the anterior clinoid process was about 10.29±0.78mm, and the width of it 9.03 ±0.71mm, as well the length of the optic strut 5.66±0.67mm, and its width 5.72±0.73mm. ②The clinoid segment of the ICA was between the distal dural ring and the proximal dural ring, with the length of 5.14±0.74mm. ③The distal dural ring was a thick membrane that fused with the adventitia of the ICA, with the thickness of 0.52±0.08mm; The proximal dural ring loosely surrounded the clinoid segment of ICA and admitted a variable number of veins from the cavernous plexus that accompanied with this segment. The thickness of the proximal dural ring was 0.22±0.06 mm. ④93% of the ophthalmic arteries originated distally to the distal dural ring, with the diameter of 1.78 ±0.46 mm. Conclusions： The clinoid segment of ICA locates in cavernous sinus, which gives off ophthalmic artery usually.