乙状窦前迷路后入路中岩斜区应用解剖研究

The applied anatomic study of retrolabinryth presigmoid approach to the middle petroclival region

目的通过对乙状窦前迷路后入路应用解剖研究,为中岩斜区显露提供显微外科解剖学基础。方法在10例(20侧)国人成人尸头(经10%甲醛固定并血管经彩色乳胶灌注)上模拟乙状窦前迷路后入路,观察中岩斜区神经血管走行分布特点、神经和血管间关系,测量相关重要数据。结果中岩斜区显微结构主要包括三叉神经(Ⅴ)、外展神经(Ⅵ)、面听神经(Ⅶ、Ⅷ)、基底动脉(BA)及小脑前下动脉(AICA)。三叉神经颅内段长度、出颅部至正中矢状面距离、矢状面角度分别为(13.82±1.84)mm,(12.90±2.02)mm,19.1°±8.0°,外展神经分别为(16.86±3.22)mm,(10.04±1.78)mm,25.6°±12.6°,面听神经分别为(14.84±2.30)mm,(23.88±2.90)mm,70.2°±5.5°。结论乙状窦前迷路后入路适用于中岩斜区显露。中岩斜区显微解剖研究及相关测量数据可为提高该区手术安全度和成功率提供参考。

Objective To provide anatomic data for approaches to the middle petroclival region through the applied anatomic study.Methods The distribution and course of nerves and arteries,the anatomical relationship of the arteries to nerves and adjacent structures of the middle petroclival region was studied in 10（20 sides） cadaveric adult heads.Colored silicone was used to inject into arteries of head to mimic retrolabinryth presigmoid approach.Results CNⅤ-Ⅷ,petrosal vein,AICA and BA were clearly depicted in the middle petroclival region.The length of intracranial segment,the distance from cranial outlet to median line and the angle to median line of CNⅤ were（13.82 ± 1.84）mm,（12.90 ± 2.02）mm,19.1° ± 8.0°,respectively.The length of intracranial segment,the distance from cranial outlet to median line and the angle to median line of CNⅥ were（16.86 ± 3.22）mm,（10.04 ± 1.78）mm,25.6° ± 12.6°,respectively.CNⅦ,Ⅷ（14.84 ± 2.30）mm,（23.88 ± 2.90）mm,70.2° ± 5.5°,respectively.Conclusion Retrolabinryth presigmoid approach can be used for lesions in the middle petroclival region