枕下远外侧入路中颈静脉孔区的显微解剖

Study of anatomy of the jugular foramen region related to microsurgery through far lateral approach

目的探讨枕下远外侧入路颈静脉孔区的显微解剖。方法对10具(20侧)成人尸头模拟枕下远外侧入路开颅,在手术显微镜下观察颈静脉孔区显微解剖,并留取图像,记录数据。结果枕下三角、寰椎横突、椎静脉丛及髁后导静脉是入路中重要解剖标志。髁窝位于枕髁后部构成颈静脉结节颅外面的后部,髁管容纳髁后导静脉。术中仅磨除髁窝既能满足该区域大多数手术暴露需要,又能保证寰枕关节的完整。结论枕下远外侧入路可充分暴露颈静脉孔区,该入路路径短,损伤小。

Objective To study the microsurgical anatomy for the far lateral approach to the Jugular Foramen.Methods Microsurgery through far lateral approach for the lesion of jugular foramen region was simulated in 10 specimens of adult cadaveric heads.The structures related to the microsurgery,especially in the jugular foramen region were observed and measured.Results The suboccipital triangle,atlantal traverse process,vertebral vein plexus and postcondylar emissary vein were the important mark in this approach.The condylar fossa forming the posterior part of the external occipital surface of the jugular tubercle was located superro-posteriorly to the occipital condyle.There was the postcondylar emissary vein in the condylar tube.There was the excellent view of the ventral dural space in the jugular foramen region and the foramen maganum,and atlanto-occipital joint was kept intact as well after the condylar fossa was extradurally drilled away.Conclusion Understanding of the microsurgical anatomy for far lateral approach to the jugular foramen is helpful to enhancing the level of the microsurgery through the approach for lesions in the jugular foramen region.