极外侧幕下小脑上锁孔入路上血管神经复合体的显微解剖研究

Microanatomical study of the upper neurovascular complex via extreme lateral supracerebellar infratentorial keyhole approach

目的研究极外侧幕下小脑上锁孔入路上血管神经复合体的解剖学特点。方法利用10具福尔马林固定、血管灌注的成人尸头标本,模拟极外侧幕下小脑上锁孔入路,应用显微镜及神经内镜对上血管神经复合体进行解剖、观察。结果极外侧幕下小脑上锁孔入路可清晰的显露三叉神经根与岩上静脉、小脑上动脉的解剖关系,小脑上动脉是三叉神经受压的主要责任血管。神经内镜的运用弥补了显微镜下对三叉神经上内侧、脑干腹侧暴露的不足。结论极外侧幕下小脑上锁孔入路可充分显露上血管神经复合体及其毗邻关系,适用于桥小脑角区上部病变的手术治疗。

Objective To study the microanatomy of the upper neurovascular complex via extreme lateral supracerebellar infratentorial keyhole approach. Methods The extreme lateral supracerebellar infratentorial keyhole approach was imitated in ten vascular perfusion adult cadaverie heads fixed in formalin, the upper neurovascular complex was dissected and observed by microscopy and neuroendoscopy. Results The extreme lateral supracerebellar infratentorial keyhole approach could fully expose the anatomical relationship of super petrosal vein, superior cerebellar artery and trigeminal nerve;the trigeminal nerve was mainly compressed by superior eerebellar artery. The application of neuroendoscopy made up for the shortcoming when exposing the superinterior of trigeminal nerve and the ventralis of brainstem. Conclusion The extreme lateral supracerebellar infratentorial keyhole approach can fully expose the upper neurovascular complex and adjacent regions, which can be apply to the operation in upper cerebellopontine angle area.