岩段颈内动脉及其相关结构的显微解剖学研究

Microsurgical anatomic study of internal carotid artery in the petrous segment

目的探讨颅底手术中颈内动脉(ICA)定位的解剖学标志。方法将20例40侧新鲜成人尸头的颞骨制成标本,连续切片后嗜伊红染色,在显微镜下观察、测量,统计岩段ICA管垂直段和水平段的平均最大直径I、CA膝部与相邻重要结构耳蜗的最短距离和平均最短距离;计算ICA管裂开的出现率。结果在岩骨,ICA管水平段居于耳蜗的前内侧,ICA管垂直段位于鼓室的下方,ICA膝部居于耳蜗的内侧;岩段ICA管垂直段的平均最大直径为(7.92±0.96)mm,水平段的平均最大直径为(5.96±0.90)mm;膝部与相邻结构耳蜗的最短距离为0.37mm和平均最短距离(2.94±0.91)mm;岩段ICA管裂开的出现率15%。结论经耳侧颅底手术、经耳前(后)-颞下窝手术入路中,可通过定位耳蜗来定位ICA,避免ICA的损伤;岩段ICA管裂开的出现率较高,增加了手术的风险。

Objective To investigate the anatomic data of internal carotid artery（ICA） in the petrous segment.Methods Microscopic anatomy study was carried out on 40 sides of human temporal bone by observing and measuring maximum average diameters of ascending and horizontal portion in ICA canal,the shortest distance and shortest average distance between the bend portion and cochlea.The occurrence rate of defect in ICA canal was calculated.Results The horizontal portion in ICA canal located at anteromedial of cochlea,the ascending portion in ICA canal located at inferior of tympanum,the bend portion of ICA was located at medial of cochlea.The maximum average diameter of ascending portion in ICA canal was（7.92±0.92） mm.The maximum average diameter of horizontal portion in ICA canal was（5.96±0.90） mm,the shortest distance between the bend portion and cochlea was 0.37 mm,the shortest average distance between bend portion and cochlea was（2.94±0.91） mm.The occurrence rate of defect in ICA canal was 15%.Conclusion The cochlea provides reference for ICA canal and offers reliable anatomical basis for minimal invasive intervention during lateral skull base surgery and the infratemporal fossa approach.The defect in ICA canal increases the risk of surgery.