经乙状窦后入路CPA区内窥镜解剖学观察  

Anatomy Study of Cerebellopontine Angle by Neuroendoscope through Retrosigmoid Approach

作　　者：李监松[1] 李俊[2] 朱贤立[3] 魏德[1] 陶剑[1] 黄继仁[1] 徐玉清[1] 

机构地区：[1]福建省立医院神经外科,福州350001 [2]广州军区武汉总医院神经外科 [3]华中科技大学同济医学院附属协和医院神经外科

出　　处：《华南国防医学杂志》2005年第1期18-20,共3页Military Medical Journal of South China

基　　金：全军医药卫生科研基金课题(01MA039)

摘　　要：目的通过神经内窥镜下桥小脑角区的解剖,为内窥镜辅助下该区域病变的手术治疗提供了解剖学依据,并探讨其临床应用价值。方法在15具福尔马林固定的成人尸头标本和1具新鲜成人尸头标本上进行桥小脑角区的窥镜解剖学研究,在窥镜下分区并测量有关数据。结果内窥镜能清晰地显示颅神经及其附近的血管,桥小脑角区从头侧至尾侧被血管神经束分为三个间隙:间隙Ⅰ、间隙Ⅱ、间隙Ⅲ,其中间隙Ⅰ又分为Ⅰa、Ⅰb亚间隙(Subspace),间隙Ⅰ、间隙Ⅱ是内窥镜主要的观察通道。结论神经内窥镜可明显改善深部术野的照明效果和显微解剖结构的识别,对显微外科手术起重要的辅助作用。Objective To study the structure of the cerebellopontine angle (CPA) zone by the neuroendoscope throngh retrosigmoid approach and its clinical value. Methods Fifteen specimens of formalin - fixed adult cadaveric heads and 1 specimen of fresh adult cadaveric head were used in the study. The structures of the CPA zone were observed by alternately using an operating microscope and a neuroendoscope. The anatomic parameters of CPA zone were measured. Results The cerebral nerves and blood vessels nearby them in the CPA zone could be observed very well by neuroendoscope. The CPA zone is rostrocaudally divided into 3 compartments, i. e. spaces Ⅰ,Ⅱand Ⅲ by the distinct bundles of the cerebral nerves and blood vessels.Space Ⅰ is subdivided into two parts again.Space Ⅰ and space Ⅱ are the main channel to explore the CPA zone. The mean distances from the porus acusticus internus, intemalostium of Meckel's cave and foramen jugulare to the genu of sigmoid sinus were respectively 45. 3mm+±3.20mm,50. 6mm±4. 2mm,40. 3mm±4. 5mm. Conclusions The neuroendoscope can make up the deficiencies of the microscope and is the importantly helpful to the microsurgical operation.

关 键 词：经乙状窦后入路 解剖学观察 CPA区 桥小脑角区 临床应用价值 福尔马林固定 显微外科手术 尸头标本 解剖学依据 解剖学研究 血管神经束 神经内窥镜 内窥镜下 手术治疗 解剖结构 辅助作用 间隙 颅神经 成人 

分 类 号：R745.11[医药卫生—神经病学与精神病学] R322.51[医药卫生—临床医学]