经海绵窦外侧壁手术入路的显微解剖

The direct approach to the cavernous sinus via the lateral wall

目的：为经海绵窦外侧壁的直接手术提供显微解剖基础。方法：收集４８侧成人新鲜海绵窦标本，在手术显微镜下解剖观测。结果：海绵窦的外侧壁由表层和深层构成，在３１．３％的标本中，两层之间有表腔出现。表腔主要位于Ｐａｒｋｉｎｓｏｎ′ｓ三角内，其形成与大脑中浅静脉（ＣＭＳＶ）的注入有关，它有三个特征可做为经外侧壁手术时的识别标志，既有ＣＭＳＶ注入、表面硬膜较其它部位颜色暗和有散在、粗大的纤维覆盖。本文测量的Ｐａｒｋｉｎｓｏｎ′ｓ三角的大小为９．８ｍｍ×１０．３ｍｍ×４．２ｍｍ，内有颈内部动脉分支走行。Ｍｕｌａｎ′ｓ三角的大小为１０．７ｍｍ×９．５ｍｍ×５．８ｍｍ。结论：了解外侧壁的显微解剖对经外侧壁的手术有临床指导意义。

Objective:To provide the microanatomic base for the direct approach to the cavernous sinus(SC) via lateral wall.Methods:Forty eight CS from fresh adult cadavers were studied in detail under the operative microscope.Results:The lateral wall of the CS was composed of superficial dural layer and deep layer.A superficial compartment(SC) between the superficial layer and the deep layer of the lateral wall could be found in 31.3% of the specimens.Most of the SC was located in the Parkinson′s triangle.The cerebral medial superficial vena(CMSV) entered the SC.The superficial dural of SC was darker than other areas and was covered by diffuse thick fibers.These three unique characteristics could be used as the identification marks for the SC.The Parkinson′s triangle was 9.8 mm×10.3 mm×4.2 mm while the Mullan′s triangle was 10.7 mm×9.5 mm×5.8 mm.Branches of internal carotid artery could be found in the Parkinson′s triangle.Conclusions:The microanatomic data of the SC is of great clinical significance for direct approach to the cavernous sinus.