基底动脉顶端相关手术入路的显微解剖研究

Study on microsurgical anatomy and related approaches of apex of basilar artery

目的研究基底动脉顶端的相关手术入路的显微解剖,评价其显露范围。方法显微解剖10例(20侧)成人尸颅标本,通过翼点入路、颞下经小脑幕入路及乙状窦前入路三种方法显露基底动脉顶端,测量各自显露的距离和范围。显露范围由术者在显微镜下行主观评分。结果翼点入路开颅骨窗到基底动脉顶端的最短距离为(63.85±2.54)mm,颞下经小脑幕入路到基底动脉顶端的距离为(66.58±2.03)mm,乙状窦前入路到基底动脉顶端的距离为(66.01±1.41)mm,三种方法翼点入路显露距离最短,而显露范围无显著统计学差异。结论翼点入路可使基底动脉顶端获得最佳显露。

Objective To study the neurosurgical microanatomy of approaches to the apex of the basilar artery to evaluate their exposure range. Mothods 10 cranial cadaver （20 sides） were researched in simulative neurosurgical approaches. Petrional approach, subtemporal transtentorial approach and presigmoid approach were used to observe the apex ofbasilar artery, and the exposure range of the three approaches was compared. Their exposure range was evaluated subjectively. Rosults The minimum exposure distance of the petrional approach, the subtemporal transtentorial approach, the presigmoid approach was （63.85±2.54）mm, （66.58±2.03） mm, （66.01±1.41）mm, respectively. Exposure distance of the petrional approach was shortest, there was no statistic difference in the subjective scorings of the three approaches. Conclusion The best exposure approach of the apex ofbasilar artery is the pterional approach.