内镜经鼻入路至岩斜区的解剖研究

Anatomical study of the endoscopic transnasal approach to the petroclival region

目的了解经鼻入路到达岩斜区的解剖标志及相对关系。方法 4例(8侧)经甲醛固定的完整成人尸头固定于头架,将内镜插入鼻腔,模拟经鼻入路到达岩斜区手术。结果测量同侧鼻孔鼻小柱到Meckle腔距离为(73.10±2.67)mm,角度为(12.65±2.16)°;对侧鼻孔鼻小柱到Meckle腔距离为(77.90±3.40)mm,角度为(18.80±0.80)°。同侧鼻孔鼻小柱到颈内动脉海绵窦段前曲段距离(75.80±3.19)mm,前曲段与中线结构的距离(9.10±1.20)mm。结论岩斜区有众多解剖标志及重要结构如颈内动脉等,了解及熟悉该区域的显微解剖对手术成功与否至关重要。

Objective To investigate the anatomical landmarks of the endoscopic transnasal approach to the petroclival region and the relative relations between them. Methods Four formaldehyde-fixed adult cadaver heads （8 sides） were used and an endoscope was inserted into the nasal cavity for simulating the surgery via a transnasal approach to the petroclival region. Results Measured the distance from the ipsilateral nostril to Meckle＇s cavity was 73.10 ± 2.67 ram, and the angle was 12.65 ± 2.16°. The distance from the contralateral nostril to the Meckle＇s cavity was 77.90 ± 3.40 mm, and the angle was 18.80 ± 0.80°. The distance from the ipsilateml nostril to the anterior bend of the intracavernous internal carotid artery was 75.80 ±3.19 mm and the distance from the anterior bend of the intracavernous internal carotid artery to the middle line was 9.10 ± 1.20 mm. Conclusions There are many anatomical marks and important structures, such as the internal carotid artery in the petroclival region. Detailed and sound knowledge of the microsurgical anatomy of this region is essential for performing precise microneurosurgery.