桥小脑角区中血管神经复合体的显微解剖学研究  

Microanatomical study on the middle neurovascular complex in cerebellopontine angle region

作　　者：张庆华[1] 张莉[1] 孙涛[1] 田继辉[1] 夏鹤春[1] 李宗正[1] 郝少才[1] 徐军[1] 

机构地区：[1]宁夏医学院附属医院神经外科,银川750004

出　　处：《中华神经外科杂志》2007年第5期394-397,共4页Chinese Journal of Neurosurgery

摘　　要：目的研究桥小脑角（cerebellopontine angle,CPA）区中血管神经复合体的显微解剖学关系,为面肌痉挛MVD手术入路选择提供解剖学依据。方法应用15具经10％甲醛充分固定并灌有乳胶的国人成人头颅湿标本,经枕下外侧小脑绒球下方入路,在4～25倍手术显微镜下对CPA区中血管神经复合体逐层解剖,观察,测量及照相。结果经枕下外侧小脑绒球下方入路可直接从尾侧方小脑绒球与舌咽神经之间的间隙显露面、听神经分离处,能够准确、安全、快捷到达CPA区相应的中血管神经复合体位置,充分暴露术野,达到完全减压效果。结论经枕下外侧小脑绒球下方入路是治疗面肌痉挛安全有效的方法,可以最大限度的减少术中损伤神经致术后颅神经麻痹等并发症。Objective To investigate the microanatomy of the middle neurovascular complex in cerebellopontine angle region. Methods 15 adult cadaver heads fixed in 10% formalin were used in this study. Ten of them were perfused with red latex through artery and blue latex through vein to facilitate their definition. The heads were placed in a head holder in a position simulating the trans-lateral suboccipital infrafloccular approach to the CPA region. Dissections were performed under x4 to 25 magnification. Special attention was given to the microanatomy related to the middle neurovascular complex in the CPA region. Results Trans-lateral suboccipital infrafloccular approach, with gentle retraction of the flocculus in a caudorostral direction perpendicular to the vestibulocochlear nerve, the root exit zone of the facial nerve can be easily observed medial to the root zone of the vestibulocochlear nerves in the supraolivary. Conclusion The advantange of trans-lateral suboccipital infrafloccular approach increases the ability to reach accurately the middle neurovascular complex in the CPA with minimal risk of damaging cranial nerves.

关 键 词：面肌痉挛 枕下外侧小脑绒球下方入路 桥小脑角 血管神经复合体 

分 类 号：R686[医药卫生—骨科学]