颞骨岩部和乳突部的显微解剖研究

Applied microanatomy of petrous portion and mastoidea of temporal bone

目的 研究颞骨岩部和乳突部的解剖,为岩斜区手术入路提供解剖学依据.方法 成人颅骨标本10例；10例10％甲醛溶液固定的成人湿头颅标本.在手术显微镜下观察,测量颞骨岩部、乳突部外侧面星点、顶乳突缝前角、乙状窦横窦之间的距离,观察乙状窦沟上曲在颅外的标志点.结果 乙状窦沟上曲转角上缘有80％在颅外对应点是顶乳缝前角；上曲转角下缘有75％在颅外对应点是星点前下方约4.67 mm.结论 顶乳缝前角、星点是幕上下联合开颅的两个关键孔,合理地利用两个关键孔可以减少术中副损伤及术后并发症的发生.

Objective To explore the regional anatomic of petrous bone and mastoideus and to provide the anatomic base for microsurgery for the lesion in the petroclivial region.Method 10 skull specimens（20 sides）and 10 fresh specimens were observed.Measurement of the distance within the asterion,the angle of parietomastoid sutures with STP （ sigmoid - transverse - superior petrosal ） were carried out.The body landmark of upper curvature of sigmoid sinus sulcus was observed.Results The configuration of the groove of sigmoid sinus （GSS） was “Z” - shape; the extracranial mark spot of upper limb of the “Z” was angle of parietomastoid sutures in 80% of all; the extracranial mark spot of the lower part of the “Z” about 4.67 mm below the front of the asterion in 75% of all.Conclusions The angle of parietomastoid sutures and the asterion are two keyholes for the combind transpetrosal approach.The appropriate use of the two keyholes may reduce collateral damage during operation and postoperative complications.