桥小脑角区下血管神经复合体的显微解剖学观察  

Microanatomical Study of the Lower Neurovascular Complex in the Cerebellopontine Angle Region

作　　者：张庆华[1] 孙涛[1] 田继辉[1] 张莉[1] 刘吉庆[1] 李国放[1] 

机构地区：[1]宁夏医学院附属医院神经外科,银川750004

出　　处：《宁夏医学院学报》2006年第2期96-98,F0002,共4页Journal of Ningxia Medical College

摘　　要：目的观察桥小脑角(CPA)区下血管神经复合体显微解剖关系。方法应用15例经10％甲醛充分固定并灌有乳胶的国人成人头颅湿标本,模拟临床枕下乙状窦后手术入路,在4-25倍手术显微镜下对桥小脑角区下血管神经复合体逐层解剖、观察、测量及照相。结果桥小脑角区下血管神经复合体主要包括舌咽神经、迷走神经、副神经及舌下神经和相关的小脑后下动脉及延髓、小脑下脚、延髓小脑沟及小脑枕下部等。小脑后下动脉行程弯曲,通常形成3个袢,这些袢接触舌咽神经根并有浅的压痕。结论桥小脑角区下血管神经复合体位置深在,结构复杂且周围毗邻脑干、小脑动脉及颅神经等重要的结构,详尽的解剖研究可提高此区的手术成功率并且尽可能保存神经功能的完整。Objective To investigate the microanatomical structure of the lower neurovascular complex. Methods Fifteen adult cadaver heads fixed in 10% formalin and peffused with latex were used for this study. Simulating the trans- suboccipital retrosigmoid approach to the CPA region, the dissection of neurovascular complex in the CPA region were performed under x4 to 25 magnification. All stages of the dissection were photographed. Results Cerebellopontine angale region the lower neurovascular complex included glossopharyngeal nerve, vagus nerves, accessory nerve and hypoglossal nerves, and interrelated to posteroinferior cerebellar artery, bulbus medulla, cerebellar peduncle, bulbus fissurae cerebelli and cerebello - napex. Posteroinferior cerebellar artery traced in a crook course and usually formed three loops, which got in touch with glossopharyngeal nerve with a shallow pressed mark. Conclusion The neurovascular complex in the cerebellopontine angale region is located deeply and has an elaborate structure, which is adjacent to brain stem, cerebeUar artery and cranial nerve. A fully structural dissection of this region could benefit the operation and integrity of nerves for the satisfactory functional survival of patients.

关 键 词：显微解剖 桥小脑角 血管神经复合体 舌咽神经痛 

分 类 号：R322[医药卫生—人体解剖和组织胚胎学]