侧颅底三维断层的临床应用解剖

Three-dimensional sectional anatomy of the lateral cranial base

目的：为侧颅底病变的影像诊断及手术入路提供解剖学基础。方法：选取成人尸体头颈部60例，分别作横、矢、冠状断层解剖。在卵圆孔和咽隐窝层面上，观察侧颅底结构的解剖学关系，测量侧颅底内重要结构的径线及结构之间的距离。结果：侧颅底横、矢、冠状断层可清晰显示卵圆孔、颈静脉孔、颞下颌关节、茎突等侧颅底结构及其毗邻关系和咽旁间隙、颞下间隙内的结构，颈内动脉、颈内静脉和咽隐窝至茎突根部的距离分别为（9．56±1．37）mm、（4．05±0．85）mm、（31．48±2．45）mm。茎突是侧颅底影像诊断及手术入路时观察各结构间位置关系、咽旁间隙分区和寻找神经、血管的骨性标志。两侧侧颅底结构呈对称性分布，重要结构的径线及结构之间的距离差异均无统计学意义。结论：侧颅底横、矢、冠状断层是分别显示咽隐窝、内耳道内结构和听小骨的最佳断层影像方式，对侧颅底病变的影像诊断和设计手术入路等具有重要意义。

Objective： To provide anatomical basis for imaging diagnosis and surgical approach of the diseases of lateral cranial base. Methods： 60 adult craniocervical corpses were selected and cut into the transverse, sagittal, coronal section. At the foramen ovale and pharyngeal recess level, anatomical relationship of the structures of lateral cranial base was observed, and measured in the diameter and distance between the important structures of lateral cranial base. Results： The transverse, sagittal, coronal section clearly displayed the foramen ovale, jugular foramen, temporomandibular joint, styloid process of lateral cranial base and its adjacent structures, and the structures in parapharyngeal space, and infratemporal space of the lateral cranial base. The distances from the internal carotid artery, internal jugular vein, and pharyngeal recess to the root part of styloid process were 9.56±1.37 mm, 4. 05±0.85 ram, 31.48±2.45 mm respectively. Styloid process was bony marker for observing the relationship among the structures, zoning the parapharyngeal space and searching the nerve and vessels when imaging diagnosis and surgical approach of the lateral cranial base. The structures of lateral cranial base were symmetrical of both side. There was no significant difference in the diameter and distance between the important structures. Conclusion： It was better sectional and imaging type to show the pharyngeal recess, structures in the internal acoustic meatus and auditory ossicle with the transverse, sagittah coronal section of lateral cranial base separately. It is of importance for imaging diagnosis and planning surgical approach of the diseases of lateral cranial base.