外侧入路和内镜腹侧入路咽旁段颈内动脉的解剖路图

An anatomical road map of the parapharyngeal internal carotid artery in lateral and endoscopic ventral approaches

目的描述外侧入路和内镜腹侧入路咽旁段颈内动脉的解剖路图,提出亚分段方案,系统全面地理解该段动脉解剖以及其与周围结构的毗邻关系。方法对5例(共10侧)新鲜尸头标本分别进行外侧入路和内镜腹侧入路解剖对照,评估咽旁段颈内动脉解剖及毗邻关系。结果自颈总动脉分叉到颈内动脉管后垂直部,顺血流方向,咽旁段颈内动脉穿行通过4种截然不同的解剖组织,据此,该段颈内动脉可以划分为神经段、肌肉段、筋膜段、骨段4个亚分段。每个亚分段的边界和毗邻的重要解剖结构被详细描述。结论咽旁段颈内动脉的解剖路图描述和亚分段方案,为降低颈内动脉损伤风险,模块化开展经外侧和内镜腹侧入路咽旁间隙等颅底手术,提供了应用解剖学依据。

Objective To describe the road map of the lateral and endoscopic ventral approaches for the pharyngeal segment of the internal carotid artery,propose a sub-segmentation scheme,systematically and comprehensively understand its anatomical details and relationships with the surrounding structures.Methods Five fresh cadaveric head specimens(10 sides in total)were dissected through lateral and endoscopic ventral approaches to evaluate the anatomical details of the parapharyngeal internal carotid artery and its relationship with the surrounding structures.Results From the bifurcation of the common carotid artery to the vertical part of the internal carotid artery,alongside the direction of blood flow,the parapharyngeal internal carotid artery passes through four distinct anatomical tissues.Based on this,the parapharyngeal internal carotid artery can be divided into four sub-segments:nerve,muscle,fascia and osseous sub-segments.The boundaries and important adjacent structures of each segment are described in detail.Conclusion The anatomical road map of the parapharyngeal internal carotid artery and the sub-segmentation scheme serving as a practical guide to navigate modular endoscopic skull base surgery of the parapharyngeal space while reduce the risk of internal carotid artery injury.