颞下窝咽旁间隙的显微外科解剖研究  

Microsurgical anatomy of the infratemporal fossa and parapharyngeal space

作　　者：刘庆[1] 袁贤瑞[1] 罗端午[1] 姜维喜[1] 潘亚文[1] 

机构地区：[1]中南大学湘雅医院神经外科,长沙市410008

出　　处：《中华显微外科杂志》2004年第4期281-283,i005,共4页Chinese Journal of Microsurgery

基　　金：湖南省卫生厅科研基金资助课题 (ZD0 2 0 5)

摘　　要：目的　研究颞下窝、咽旁间隙的显微外科解剖 ,探讨该区域的解剖境界及临床意义。　方法　选择经 10 %福尔马林固定成人头颈标本 10具 ,显微镜下模拟耳前颞底 颞下窝入路的手术操作 ,逐层显露颞下窝和咽旁间隙 ,研究该区域肌肉、神经血管和骨性结构的相互及定位标志。　结果　颞下窝内的主要结构有翼内肌、翼外肌、上颌动脉、翼静脉丛、下颌神经及其分支等。茎突隔膜将咽旁间隙分为茎突前区和茎突后区 ,颈内动脉、颈内静脉及Ⅸ、Ⅹ、Ⅺ、Ⅻ脑神经等重点结构位于茎突后区内。茎突隔膜由二腹肌后腹、茎突肌群、茎突舌骨韧带和茎突下颌韧带、茎突咽筋膜和由二腹肌延至胸锁乳突肌的筋膜构成。　结论　颞下窝为下颌骨和翼内侧板之间的区域 ,咽旁间隙系颞下窝后方、鼻咽外侧及颈椎腹侧的区域 ;茎突隔膜包绕颈内动脉 ,为颞下窝咽旁间隙区域的重要解剖标志。Objective To study the microsurgical anatomy of the infratemporal fossa and parapharyngeal space,and to describe the anatomic definitions and the surgical significance of it Methods The microsurgical anatomy of the infratemporal fossa and parapharyngeal space was observed in 10 fixed cadavers each consisting of the whole head and neck and injectegd with latex The dissections were performed step by step using microsurgical techniques and instruments via preauricular subtemporal infratemporal approach,with special emphasis on the relationships of the muscles,nerves,arteries,and veins and the surgical landmarks in this region Results The structures located in the infratemporal fossa are the pterygoid muscles and venous plexus and the branches of the maxillary artery and mandibular nerve The parapharyngeal space is subdivided into prestyloid and poststyloid compartments by the stylid diaphragm,which is formed by the posterior belly of the digastric muscle,the styloid muscle group,the stylohyoid and stylomandibular ligaments,the stylopharyngeal fascia,and the fascia extending from the digastric muscle to the sternocleidomastoid muscle Conclusion The infratemporal fossa is bounded laterally by the ramus of the mandible and deeply by the medial pterygoid plate of the sphenoid bone The parapharyngeal space is located posterior to the the infratemporal foos and lateral to the pharynx and ventral to the cervical vertibrae The styloid diaphragm covers the high cervical carotid artery and is the important anatomic landmark in these regions [Key words] Infratemporal fossa; Parapharyngeal space; Microsurgical anatomy; Styloid diaphragm

关 键 词：颞下窝 咽旁间隙 茎突 显微外科解剖 颈内动脉 二腹肌 舌骨 隔膜 研究 模拟 

分 类 号：R651[医药卫生—外科学]