海绵窦区的显微解剖及其临床意义

Microsurgical Anatomy of the Cavernous Sinus Region and Its Clinical Meanings

目的为海绵窦病变的临床治疗提供参考。方法在2～8倍手术显微镜下解剖、观察、测量和记录海绵窦周围骨、硬膜、动脉和颅神经的关系以及海绵窦内的静脉间隙和交通等。结果海绵窦有丰富的静脉交通,不仅可使颈内动脉海绵窦瘘和海绵窦硬脑膜动静脉瘘的临床表现复杂多变,也可与潜在的静脉引流开放促成血管内栓塞治疗后的复发。结论海绵窦的解剖对选择适当的血管内治疗途径和合适的栓塞材料也是重要的。

Objective To provide data for clinical treatment of the lesions in the cavernous sinus region.Method Dissection was carried out under 2～8 power operative microscope in 18 adult cadaver head.The relationships among the cavernous sinus,the adjacent skull base bone,dura,artery and cranial nerves,the venous space and venous communication of cavernous sinus were observed, measured and recorded.Results That the cavernous sinus has rich venous communications not only makes the clinical manifestations of carotid cavernous fistula and cavernous dural arterial-venous fistula more complex,but also makes recurrence of the lesions possible by opening the potential venous drainage after the endovascular treatment.Conclusions The anatomy of the cavernous sinus region is important to selecting proper way and embolic material of endovascular treatment for the vascular lesion in the region.