卵圆孔的解剖学研究及其临床意义

Morphometric anatomical study of foramen ovale and its clinical significance

目的观察卵圆孔(FO)的形态及变异,为三叉神经痛、海绵窦区肿瘤的诊治提供参考依据。方法选取83例结构完整的颅骨标本,采用游标卡尺测量卵圆孔长度、宽度。分别测量FO与同侧颞骨岩尖(APP)、后床突(PCP)之间的距离,分别记为FO-APP,FO-PCP;记录FO形态特点。结果①FO具有如下形态:椭圆形98例;“D”字型60例;三角形3例;圆形2例;不规则形2例;缝1例。FO内具有骨棘3例,骨结节3例,骨刺2例。②左侧FO长度、宽度分别为(7.37±1.21)和(4.28±0.99)mm;FO与颞骨岩尖、后床突距离分别为(9.88±3.54)和(15.68±3.49)mm;右侧FO长度、宽度分别为(7.84±1.18)和(4.06±0.99)mm;FO与颞骨岩尖、后床突距离分别为(9.44±3.20)和(16.74±4.57)mm。③右侧FO长度高于左侧(P<0.05);左侧FO宽度与FO-APP呈负相关(r=-0.526,P=0.043);右侧FO宽度与FO-APP呈负相关(r=-0.341,P=0.039);右侧FO宽度与FO-PCP呈负相关(r=-0.369,P=0.047)。结论分析FO与颞骨岩尖、后床突等重要结构解剖学参数不仅提高脑外科医生对颅中窝解剖特征的认识,而且对三叉神经减压、海绵窦肿瘤的诊疗具有重要意义。

Objective To observe the morphology and variation of foramen ovale (FO) and provide reference for the diagnosis and treatment of trigeminal neuralgia and cavernous sinus tumors. Methods Totally 83 adult dry skulls were examined with a sliding caliper. The lengths and widths of the FO, distances between the FO anda pex partis petrosa (FO-APP) and distances between the FO and posterior clinoid process (FO-PCP) were measured in an intracranial view of the skull. Results ①The FO displayed a shape of ovale in 98 cases,“D” in 60 cases, triangular in 3 cases, round in 2 cases, irregular in 2 cases and slit in one case. The bony spine was found in 3 cases, bony tubercle in 3 cases and bony spur in 2 cases.② In the left side, the length and width of FO were (7.37±1.21 mm) and (4.28±0.99 mm);distances of FO-APP and FO-PCP were (9.88±3.54 mm) and (15.68±3.49 mm). In the right side, the length and width of FO were (7.84±1.18 mm) and (4.06±0.99 mm);distances of FO-APP and FO-PCP were (9.44±3.20 mm) and (16.74±4.57 mm).③ There was statistical significance between the lengths of both sides P(< 0.05). There was negative correlation between the width of the FO andF O-APP in the right side, FO and FO-PCP in the right side, and the FO and FO-APP in the left side (r =-0.341, r =-0.369, r =-0.526, P < 0.05). Conclusions The analysis of FO, petrous apex of temporal bone, posterior clinoid process and other important structural and anatomical parameters not only improves the understanding of the anatomical characteristics of the middle cranial fossa, but also has important significance in the diagnosis and treatment of trigeminal nerve decompression and cavernous sinus tumors.