颞下经小脑幕入路至上岩斜区应用解剖研究

Study of Applied Anatomy Related to Neurosurgery through Subtemporal Transtentorial Approach to Superior Petroclival Region

目的通过对颞下经小脑幕入路应用解剖研究,为上岩斜区手术入路提供显微外科解剖学基础。方法在10具(20侧)经10%甲醛固定并且血管经彩色乳胶灌注的国人成人尸头上模拟颞下经小脑幕入路,观察上岩斜区神经血管走行分布特点,神经和血管间关系,测量相关重要数据。结果上岩斜区显微结构主要包括动眼神经、滑车神经、Labbe静脉、大脑后动脉和小脑上动脉。滑车神经穿入小脑幕游离缘处距动眼神经约[5.50±1.82(4.24～6.98)]mm,Labbe静脉各分支游离长度(9.56±4.06)～(14.78±4.60)mm。结论颞下经小脑幕入路适用于上岩斜区显露。对上岩斜区显微解剖研究及测量相关数据可提高该区手术安全度和成功率。

Objective To provide the anatomic data for the neurosurgery through subtemporal transtentorial approach to the superior petroclival region. Methods The neurosurgery through subtemporal transtentorid approach to the superior petroclival regions was simulated in 10 （20 sides） formalin-fixed cadaveric adult heads, where the arteries were infused into with colored emulsion. The anatomy related to the neurosurgery through the subtemporal transtentorial approach to the superior petroclival regions, including run and distribution of the vessels and nerves, relationship among the vessels, nerves and adjacent structure, were observed and measured. Results There were the such as Labble veins, posterior cerebral arteries, oeulomotor nerves, trochlear nerves, and superior cerebellar arteries and so on in the superior petroclival regions. The distance from the point where the trochlear nerve entered into the edge of the tentorium to the oculomotor nerve was [5.50±1.82（4.24-6.98）]mm. The length of the branches of Labble vein was （9.56 ±4.06）-（14.78 ±4.60）mm. Conclusions The subtemporal, transtentorial approach is adapted to the exposure of the superior petroclival region. The present results are helpful to the increase in the safety and successful rate of the neurosurgery in the superior petroclival region.