基底动脉中段相关手术入路的显微解剖研究

Microanatomical study on related approaches of the middle trunk of basilar artery

目的研究显露基底动脉中段的相关手术入路的显微解剖,评价其显露范围及优缺点。方法显微解剖10例(20侧)成人头颅标本,通过颞下经小脑幕入路、乙状窦前入路及经口入路3种方法显露基底动脉中点,测量各自的距离和范围。显露范围由术者行主观评分。结果经口入路到基底动脉中点的距离为(16.86±2.11)mm,颞下经小脑幕入路到基底动脉中点的距离为(72.88±2.49)mm,乙状窦前入路到基底动脉中点的距离为(56.29±1.78)mm。经口入路显露距离最短,乙状窦前入路次之,颞下经小脑幕入路最长。显露范围经口入路最小,颞下经小脑幕入路和乙状窦前入路无明显统计学差别。结论乙状窦前入路显露基底动脉中段距离较短,操作空间较大,可作为首选的手术入路。

Objective To study the neurosurgical microanatomy of approaches related with the middle trunk of basilar artery. Methods 10 cranial cadaver （20 sides） were researched in mimicing neurosurgical approaches. Transoral transclival ap- proach, subtemporal transtentorial approach and presigmoid approach had been respectively used to observe the middle trunk of basilar artery, and the distance and the revealing condition of several related approaches was compared. Their revealing range was evaluated subjectively. Results The revealing distance of transoral approach, subtemporal transtentorial approach and presigmoid approach were 16.86±2.11 mm, 72.88±2.49 mm and 56.29±1.78 mm, respectively. The revealing distance of transoral approach was shortest, that of presigmoid approach was longer and that of subtemporal transtentorial approach was longest. The subjective revealing scope of transoral approach was smallest, that of subtemporal transtentorial was the same as that of presigmoid approach in statistics. Conclusion The best neurosurgical approach of the middle trunk of basilar artery is the presigmoid approach.