Kawase’s入路对岩斜区暴露范围的量化研究

Quantitative research of exposure extent of the petroclival region by Kawase's approach

目的量化研究Kawase’s入路对岩斜区的暴露面积,明确Kawase’s入路适用范围,为临床手术入路的选择提供解剖学基础。方法成人头颅湿标本8例,采用Kawase’s入路进行手术模拟操作,观察神经、血管走行关系,并测量重要结构,采用CT三维重建测量岩斜区暴露范围。结果 Kawase’s三角磨除深度为(1.16±0.14)cm,岩斜区暴露面积为(5.48±0.71)cm2,暴露范围下限距鞍背(2.26±0.22)cm。该入路可暴露中上斜坡、蝶岩裂部和海绵窦后部。结论 Kawase’s入路适用于位于内听道内侧中上斜坡、蝶岩裂部及颅中窝底肿瘤,伴或不伴海绵窦侵袭。

Objective To quantitatively study the exposure area of the petroclival region and identify the applicability of Kawase＇s approach to provide the anatomic basis for the choice of surgical approach.Methods Eight cadaveric head specimens were used to observe the running of the nerve and blood vessel and measure important structures by simulation surgery via Kawase＇s approach.The exposure extent of the petroclival region was measured by CT three-dimensional reconstruction.Results The depth of Kawase＇s triangle after drilling was 1.16 ± 0.14 cm,the exposure area of the petroclival region through Kawase＇s approach was 5.48 ± 0.71 cm2,and the distance from the low limit of the exposure to the dorsum sellae was 2.26 ± 0.22 cm.Kawase＇s approach provided the exposure of upper and medial clivus,sphenopetrosal fissure and posterior cavernous sinus.Conclusions Kawase＇s approach is appropriate for tumors,with or without cavernous sinus invasion,located on the upper and middle clivus at the medial side of the internal auditory canal,sphenopetrosal fissure and middle cranial fossa skull base.