侧颅底及颅后窝手术入路应用解剖

APPLIED ANATOMY FOR APPROACHES OF THE LATERAL SKULL BASE AND POSTERIOR FOSSA

目的 :研究侧颅底手术入路和乙状窦后进路相关的应用解剖。方法 :通过测量 4 0例颅骨 ,确定茎突根部至侧颅底、星点至颅后窝各孔裂间连线的长度和各连线与正中矢状面所成角度。结果 :茎突根部至圆孔、棘孔、颈动脉管外口、颈静脉窝、舌下神经管外口的距离和夹角分别为 (2 4 .2± 2 .5)mm〔(149.8± 5.2 )°〕、(18.9± 2 .6 )mm〔(154.6± 5.0 )°〕、(9.1± 1.9)mm〔(12 0 .4± 8.1)°〕、(3 8± 1 6 )mm〔(85.9± 5.4 )°〕、(16 6± 2 1)mm〔(85.5± 5.2 )°〕。星点至三叉神经压迹、内耳门、颈静脉孔、舌下神经管内口的距离和夹角分别为 (58 3± 3 3)mm〔(139.4± 5.6 )°〕、(4 4 6± 7 9)mm〔(134.5± 7.0 )°〕、(4 2 9± 3 5)mm〔(12 8.3± 8.0 )°〕、(55 7± 3 7)mm〔(116 .7±7.8)°〕。结论 :围绕两种手术入路测量所得结果 。

Objective:To study the related anatomy of surgical approaches to the lateral skull base and posterior cranial fossa.Methods:The length of lines linking root of styloid to the structures under lateral skull base and asterion to the structures in posterior cranial fossa and the angles between these lines and median vector were measured in 40 cranium.Results:The distances and angles from root of styloid to oval foramen,spinose foramen,external canalis carotid aperture,jugular fossa,external canalis hypoglossal aperture were (24.2±2.5)mm〔(149.8±5.2)°〕,(18.9±2.6)mm〔(154.6±5.0)°〕,(9.1±1.9)mm〔(120.4±8.1)°〕,(3.8±1.6)mm〔(85.9± 5.4)° 〕 and (16.6±2.1)mm〔(85.5±5.2)°〕,respectively.The same items mentioned above from asterion to trigeminal impression,internal auditory foramen,jugular foramen,internal canalis hypoglossal aperture were (58.3±3.3)mm〔(139.6± 5.6)° 〕,(44.6±7.9)mm〔(134.5±7.0)°〕,(42.9±3.5)mm〔(128.3±8.0)°〕 and (55.7±3.7)mm〔(116.7±7.8)°〕 respectively.Conclusion:These measurements will benefit the design of surgical treatment and provide some useful references for defining the position of important structures in operations.