上颈椎咽后间隙入路安全显露区域的测量

The Applied Anatomy Study of Superior Cervical Through the Retropharyngeal Space

目的通过对甲状腺上动脉、喉上神经、舌动脉、舌下神经与舌骨大角尖部进行解剖学测量,为经咽后间隙入路行上颈椎显露寻找相对安全显露区域。方法 17具(33侧)10%福尔马林固定的灌注红色乳胶成人头颈部标本,以舌骨大角尖部(THB)为解剖学参照标志,观察并测量甲状腺上动脉、喉上神经、舌动脉、舌下神经与舌骨大角尖部的距离及相对关系。结果距舌骨大角尖部后下方0.907±0.131 cm以内,舌骨大角尖部下方1.196±0.283 cm以上,特别是上述两点连线的内上方区域,是避免甲状腺上动脉、喉上动脉损伤的相对安全范围;距舌骨大角尖部后下方0.627±0.283 cm处的内上方区域,是避免喉上神经损伤的相对安全范围;舌骨大角尖部内上方0.864±0.268 cm处后下方的区域是避免舌动脉损伤的相对安全显露范围;舌骨大角尖部内上方1.426±0.263 cm处后下方区域是避免舌下神经损伤的相对安全范围。结论舌骨大角尖部(THB)后下方0.627±0.283 cm处内上方向,THB前内上方0.864±0.268 cm后下方之间的区域是咽后间隙入路行上颈椎显露的相对安全区域。

Objective To provide anatomical data and confirm the safe region for exposion of atlantoaxial joint through the operative route of retropharyngeal space in upper cervical vertebra. Methods Seventeen （ 33 sides ） adult head and neck cadavers which were soaked in the liquor of formalin perfused with red latex were observed, Carotid triangle and such surrounding structures as carotid sheath, superior thyroid artery, superior laryngeal nerve ,lingual artery ,hypoglossal nerve, the body of hyoid bone and the tip of the greater horn of the hyoid bone（THB） were measured. Results The safe space of su- perior thyroid artery and surperior laryngeal artery is between the above interior region of below 0. 907±0. 131 cm after THB and the above region of below 1. 196± 0.283 cm after THB;The safe space of surperior laryngeal nerve is the above interior region of below 0.627± 0.283 cm after THB ; The safe space of lingual artery is the below after region of interior 0. 864 ±0. 268 cm above THB;The safe space of lingual artery is the below after region of interior 0. 864 ±0.268 cm above THB;It was safe space of hypoglossal nerve, Which is the below after region of interior 1. 426± 0.263 cm above THB. Conclusion It could be safely used through retropharyngeal space in upper cervical vertebra,which is between the above interior region of below 0. 627 ± 0.283 cm after THB and the below after region of interior 0. 864 ± 0.268 em above THB.