上颌窦-翼腭窝-海绵窦手术入路的显微解剖学研究  

Microsurgical anatomy of the transmaxillary-pterygopalatine fossa approach to cavernous sinus

作　　者：杨军 [1] 于春江 [1] 石祥恩 [1] 王忠诚 [2] 董浩 [1] 张鹏飞 [2] 高秀来 [3] 

机构地区：[1]100038,北京三博复兴脑科医院神经外科、首都医科大学附属复兴医院神经外科 [2]北京市神经外科研究所 [3]首都医科大学解剖学教研室

出　　处：《中华神经医学杂志》2005年第3期250-253,共4页Chinese Journal of Neuromedicine

基　　金：首都医科大学基础与临床合作基金(2001-JL-0110)

摘　　要：目的对上颌窦-翼腭窝-海绵窦手术入路相关结构进行显微外科解剖学研究,为手术入路提供解剖学基础。方法利用10例经福尔马林固定的国人成人尸头共20侧,完全模拟该手术入路,对入路相关解剖标志进行了详细地显微解剖、观察、拍摄、测量和统计。结果上颌窦后壁与翼腭窝区结构复杂,有重要的神经和血管经过,是颅前、中窝与鼻腔、窦肿瘤互相蔓延的通道。该入路可较好地显露海绵窦前外侧相关的结构。结论该手术入路是海绵窦入路的一个特殊方法,拓展海绵窦手术入路的路径,为利用颅底硬膜外间隙进行入路提供了依据。Objective To study the microsurgical anatomy of the transmaxillary-pterygopalatine fossa approach to cavernous sinus so as to provide anatomical evidence for surgical approach. Methods 10 cases (20 sides) of Chinese adult cadaver heads fixed by 10% formalin were studied. The relative anatomical landmarks of the maxillary-pterygopalatine fossa approach to cavernous sinus were dissected under microscope, observed, photographed, measured and analyzed. Results The posterior wall of maxillary sinus and pterygopalatine fossa, as the spreading passage of tumors between the cranial fossa (anterior and middle) and the nasal cavities and sinuses, had complex structures, including important nerves and vessels. The approach could better expose the cranial nerves within the anterior-lateral wall of cavernous sinus. Conclusion The operative approach of the cavernous sinus is expanded via the maxillary-pterygopalatine fossa approach, which is a special approach type and provide the basis for the operative approach via epidural interspace of the skull base.

关 键 词：手术入路 解剖学研究 海绵窦 翼腭窝 上颌窦 福尔马林固定 解剖学基础 硬膜外间隙 显微外科 相关结构 成人尸头 显微解剖 解剖标志 

分 类 号：R322.81[医药卫生—人体解剖和组织胚胎学]