腭鞘管、翼管与岩骨段颈内动脉的内镜手术应用解剖与进展

Applied anatomy and advances of endoscopic surgeries in the palatovaginal canal,vidian canal and petrous internal carotid artery

近年来,国外内镜下围绕着翼腭窝及颈内动脉区病变的内镜手术逐渐开展,对翼腭窝及其通道腭鞘管、翼管区的解剖研究亦不断深入。国内相关学者内镜下经鼻入路岩尖、颈内动脉区、斜坡及颅颈交界区解剖和临床应用解剖研究极少报道,究其原因,主要还是因为该区域重要解剖结构复杂而多变异,缺乏可以信赖的恒定的解剖标记,导致内镜颅底手术进展缓慢。内镜手术中,定向、定位障碍是耳鼻喉科医生和神经外科医生面临的最大风险[1]。

In recent years,the lesions of the pterygopalatine fossa and the carotid artery are treated with transnasal endoscopic approaches in foreign countries gradually. The anatomy of the pterygopalatine fossa and its canals,such as palatovaginal canal and vidian canal,have been studied thoroughly. However,literatures about the anatomy and clinical applied anatomy of the petrous apex,internal carotid artery,c livus and cranio-vertebral junction space were reported rarely in China. The main causes to cast negative influence on the endoscopic skull base surgery are the complicated structures,anatomical variations and lack of reliable anatomical landmarks. Disorientation of the surgical field is the major risk faced by otorhinolaryngologists and neurosurgeons during endoscopic surgery.