颞骨岩部在岩斜区手术入路中的应用解剖

Applied anatomy of petrous bone in operation approach of petroclival region

目的 :为颞骨岩部的临床应用提供解剖学依据。方法 :对 15例成人尸头湿标本的颞骨岩部及其周围结构按手术入路分别从前、外、后三个方向进行显微解剖研究。结果 :①磨除颞骨岩部尖 ,可以向下向外移动三叉神经 ;②外展神经是磨除颞骨岩部的内限 ;③面神经分为 5段 :颅内段 (12 .3 2mm)、内耳道段(9 .18mm)、迷路段 (5 .14mm)、鼓室段 (11.82mm)、乳突段 (17.90mm) ;④颈静脉球高度变异较大 ;⑤颈内动脉岩部膝距耳蜗 2 .65mm ,其水平段平行于岩大神经 ;结论 :①岩大神经是从前方磨除颞骨岩部十分重要的标志 ;

Objective:To provide anatomic basis for clinical application of petrous bone.Methods:A microanatomy study of petrous bone along with the structures around it was performed on fifteen cadaveric adult heads specimens from anterior,lateral,posterior direction by operation approach.Results:①Trigeminal nerve can be moved towards inferior and lateral by drilling the petrous apex;②Abducens nerve was the medial limit of drilling petrous bone; ③Facial nerve was divided into 5 segments: intracranial segment(12.32 mm),internal acoustic meatus segment(9.18 mm),labyrinthine segment(5.14 mm),tympanic segment(11.82 mm) and mastoid segment(17.90 mm);④The height of jugular bulb had great variation; ⑤The distance between genu of petrous carotid and cochlea was 2.65mm.The distance from genu of petrous carotid to cochlea was 2.65 mm.The horizontal segment of petrous cartoid was parallel with the greater petrosal nerve.Conclusions:①The greater petrosal nerve is an important landmark in drilling anterior petrous bone;②Petrosigmoid intersecion and fissure for endolymphatic sac are important landmarks in drilling lateral and posterior petrous bone.