颈内动脉颅底段重要解剖标志点的影像学测量

Imageological measurement of anatomical landmarks of petrous segment of the internal carotid artery

目的了解正常成人颈内动脉岩内段各点与咽鼓管圆枕的距离,为鼻内镜颅底相关手术的安全操作提供重要的参考依据。方法选择50例正常成人颅底为研究对象,采用薄层高分辨率CT扫描和图像放大,三维重建,对颈内动脉岩内段距咽鼓管圆枕的距离进行测量,并对测量值进行统计学处理。结果咽鼓管圆枕距离同侧破裂孔距离为(17.440±0.213)mm,距离同侧颈内动脉管外口(27.322±0.271)mm,距离右侧卵圆孔(22.000±0.323)mm。男性咽鼓管圆枕与左侧卵圆孔距离为(21.122±0.314)mm,女性咽鼓管圆枕与左侧卵圆孔距离为(21.228±0.617)mm。结论该研究为鼻内镜颅底手术的安全操作提供了重要的参考依据,对术中暴露和保护岩骨段颈内动脉极为重要,能有效避免术中损伤颈内动脉造成致死性大出血。

Objective To measure the distances between the torus tubarius and different points of the petrous segment of the internal carotid artery to provide references to safe performance of cranial base surgery via transnasal endoscopic approach.Methods The study was carried out in 50 normal adults.The external aperture of internal carotid canal,foramen ovale,foramen lacerum were chosen as the landmarks of operation.The distances between these three foramen and the torus tubarius were measured separatively through three-dimensional reconstruction in high resolution computer tomography.Results The measured distances between torus tubarius and foramen lacerum and external aperture of internal carotid canal were（17.440±0.213）mm and（27.322±0.271）mm respectively.The distance between torus tubarius and foramen ovale of the right side was（22.000±0.323）mm,while those of the left side were（21.122±0.314）mm and（21.228±0.617）mm in male and female respectively.Conlusion The study provides important references to avoiding the internal carotid artery injury,which is a fatal complication in cranial base surgery via transnasal endoscopic approach.