复式展神经的显微解剖学  

Microanatomical study on the duplicated abducent nerve

作　　者：孙骏[1] 邵君飞[1] 

机构地区：[1]南京医科大学附属无锡第一医院神经外科,无锡214002

出　　处：《江苏医药》2007年第9期883-884,F0003,共3页Jiangsu Medical Journal

摘　　要：目的研究复式展神经的解剖结构、走向与周围结构的关系,探讨其临床意义。方法经甲醛固定的国人成年头颅标本16例(32侧),观测其中复式展神经标本的位置、走向及重要毗邻关系。结果32侧标本中发现5侧是复式展神经(15.6%),其中4侧(80%)在右侧,1侧(20%)在左侧。2侧(40%)展神经自脑干桥延沟出脑时为独立的两干,其余3侧(60%)展神经离开脑干时为单一神经干,在脑池段分裂成两干。所有标本中复式展神经都在颈内动脉后膝水平部分并成单一神经干。本组标本中,发现有一侧起端为单干的复式展神经,在行径Gruber韧带时,一神经干从韧带上通过,另一干从韧带下通过。有1侧(3.1%)复式展神经标本,小脑前下动脉从两个展神经干之间穿过。结论在展神经邻近区域手术时需考虑复式展神经存在的可能,注意辨认和保护。Objective To study the anatomic structure, course and relationship with other structures of the duplicated abducent nerve, and investigate the surgery-related implications. Methods The location, course and its adjacent structures of five duplicated abducent nerves were studied in 32 sides of formalined adult cadaver head specimens. Results Duplicated abducent nerves were found in 5 （15.6 %）of 32 specimens（4 on the right side, 1 on the left）. In two cases（40 %）, the nerves originated from the pontomedullary sulcus as two independent trunks. In the other three cases（60%）, the nerves originated as a single trunk, and then split into two subtrunks in the cisternal segment. In all specimens, the duplicated abducent nerves merged to form a single trunk at the level of the horizontal portion just after the posterior genu of ICA. In one specimen, the nerve originated as a single trunk passing through the Gruber ligament, and then divided into two subtrunks（one ran below and another one ran above it）. In one case,the AICA ran between two abducent nerve bundles. Conclusion While performing a surgery near the abducent nerves, the operator should consider the possibility of an existing duplicated abducent nerve. Abducent nerve must be indentified and protected carefully.

关 键 词：展神经 复式展神经 Gruber韧带 Dorello管 

分 类 号：R322[医药卫生—人体解剖和组织胚胎学]