口内径路咽旁间隙的内镜解剖结构

Transoral endoscopic dissection of parapharyngeal space

目的研究口内径路咽旁间隙的内镜解剖结构,了解颈内动、静脉及后组颅神经等解剖结构的毗邻关系,为内镜下口内径路咽旁间隙肿瘤切除提供解剖依据。方法对新鲜尸头5例(共10侧),进行内镜下经口内径路咽旁间隙解剖。结果咽上缩肌是进入茎突前间隙的标志,茎突咽肌、茎突舌肌是进入茎突后间隙的标志,茎突后间隙包含重要的血管及后组颅神经。结论内镜下口内径路可充分暴露咽旁间隙的结构,茎突咽肌、茎突舌肌是保护茎突后间隙的重要解剖标志。颈内动脉位于咽上缩肌的外侧,靠近咽上缩肌内侧能够保护颈内动脉。

Objective To investigate the transoral anatomic characteristics of parapharyngeal space. Methods A total of5 fresh cadaver heads（ including 1 injected cadaver head） were dissected to illustrate the transoral approach of parapharyngeal space anatomy. Results The superior constrictor muscle was the landmark to enter the prestyloid space. The stylopharyngeus and styloglossus muscles were critical marks which divided the parapharyngeal space into 2 parts. Posterior to these muscles and laterally to the superior constrictor muscle,the internal carotid artery,internal jugular vein,and lower cranial nerves were identifiable. Conclusion Our dissection emphasizes the role of the stylopharyngeus and styloglossus muscles. The lateral surface of the superior constrictor muscle is essential to protect the internal carotid artery.