前床突的显微外科解剖  

Microsurgical anatomy of anterior clinoid process

作　　者：陶存山[1] 尹嘉[2] 楼美清[2] 王冰心[2] 汪亮[1] 李文[1] 蒋建华[1] 卢亦成[2] 

机构地区：[1]中国人民解放军359医院神经外科,镇江212001 [2]第二军医大学附属长征医院神经外科

出　　处：《解剖学研究》2005年第3期179-182,共4页Anatomy Research

摘　　要：目的了解前床突及其周围结构的解剖特点,并提供相应的解剖依据。方法用15例成人干颅骨和15例正常成人尸体头部标本,在手术显微镜下观察测量前床突及其邻近结构。结果视神经长度,前床突切除前为(9.5±1.8)mm,切除后为(21.3±2.9)mm;颈内动脉长度,切除前为(9.9±2.0)mm,切除后为(13.8±2.5)mm;视神经颈内动脉三角的宽度,切除前为(3.6±1.0)mm,切除后为(12.5±2.3)mm。前床突切除后所获得床突间隙几何空间的外侧横截面积为(2.1±0.3)cm2。结论磨除前床突后形成的床突间隙,增加了手术操作空间;前床突切除后在显露视神经颈内动脉三角的最大宽度方面能增加3～4倍的显露;可充分显露颈内动脉床突下段,增加了视神经鄄颈内动脉间隙,有利于该区域病变的处理。Objective To provide detailed anatomical knowledge of anterior clinoid process and its surrounding structures. Methods The osseous structures of anterior clinoid process were observed in 30 sides of dry adult cadaveric head specimens. The course and relationship of nerves and vascular structures around anterior clinoid process were observed in 30 sides of formalin fixed cadaveric heads. Results Optic nerve length was （9.5±1.8） mm and （21.3±2.9）mm; internal carotid artery length was（9.9±2.0）mm and（13.8±2.5）mm; OCT width was（3.6±1.0）mm and（12.5±2.3）mm; OCT length was（9.6± 2.3）ram and （22.0±3.2）mm before and after removal of the anterior clinoid process respectively. Conclusion Anterior clinoidectomy could provide a twofold increase in exposure of the optic nerve length and the OCT length, as well as a three fold to fourfold increase in the maximum OCT width. This dramatically improves surgical exposure in the suprasellar and periclinoid regions and facilitate to resect tumors in this area.

关 键 词：前床突 视神经 颈内动脉区 显微解剖 前床突切除 显微外科解剖 颈内动脉三角 手术操作空间 显微镜下观察 床突间隙 

分 类 号：R322[医药卫生—人体解剖和组织胚胎学]