内镜下迷路后径路桥小脑角区结构定位  

Landmark of cerebellopontine angle surgery aided by endoscope

作　　者：朱杭军[1] 廖建春[2] 杜云翔[3] 李前文[3] 王益龙[4] 黄杰[1] 徐岩[1] 

机构地区：[1]中国人民解放军第八二医院耳鼻咽喉科 [2]第二军医大学附属长征医院耳鼻咽喉科,上海200003 [3]中国人民解放军第八二医院肿瘤科 [4]中国人民解放军第八二医院神经外科,江苏淮安223001

出　　处：《中国临床解剖学杂志》2007年第1期23-24,共2页Chinese Journal of Clinical Anatomy

摘　　要：目的:探讨内镜下迷路后径路脑桥小脑三角区手术的解剖学标志及定位方法。方法:在15例30侧成人尸头上模拟迷路后桥脑小脑角区内镜手术,观察内耳门以及各组颅神经之间的关系,测量其外缘在颞骨岩部骨板平面上距颞骨表面距离,前缘距三叉神经半月节距离、下缘距舌咽神经距离,上缘距岩上窦距离。结果采用SPSS进行统计学分析。结果:内耳门外缘距颞骨表面距离为(33.82±2.80)m m,三叉神经位于其前上方,距其外缘距离为(8.10±1.15)m m,展神经位于内耳门前方,三叉神经的下方,滑车神经为一细长神经,行于三叉神经前上方,舌咽神经恰位于内耳门下方,其距内耳门下缘约(6.26±1.05)m m,其下依次为迷走神经、副神经,内耳门距岩上窦距离为(4.96±1.40)m m。结论:内耳门位于颞骨岩部中间,位置不易受病变影响相对固定,且居于各组颅神经中间位置,当其能在术野中暴露良好时为理想的定位标志,舌咽和迷走神经因其形态特征也可作为定位标志。Objective： To discuss anatomic markers and locating way of pontocerebellar trigone in endoscopic surgery approaching through posterior labyrinth. Methods： Simulating the process of the endoscopic surgery in cerebellopontine angle, the structures around the internal acoustic porus were observed in 15 adult cadaveric specimens, and the distances from trigeminal nerve, glossopharyngeal nerve, temporal bone surface, and superior petrosal sinus to it were measured. Results： The distance from the exterior margin of temporal bone to internal acoustic porus was about （33.82±2.80）mm. Trigeminal nerve located at the anterosuperior part of internal acoustic porus, and the distance from it to internal acoustic porus was （8.10± 1.15）mm. The abducens nerve located at the anterior aspect of internal acoustic porus, and the inferior aspect of trigeminal nerve. The trochlea nerve located at the anterosuperior aspect of trigeminal nerve. The glossopharyngeal nerve just located at the inferior aspect of the internal acoustic porus, with the distance between them of （6.26±1.05）mm. The vagus nerve and accessory nerve located lowly the glossopharyngeal nerve. The distance from the internal acoustic prous to superior petrosal sinus was about （4.96±1.40）mm. Conclusions：The internal acoustic porus locates at the center of the cerebellopontine angle. For their unique shape, it is a perfect landmark during the operation exposing vagus nerve and glossopharyngeal nerve.

关 键 词：内耳门 内镜 桥脑小脑三角区 三叉神经 舌咽神经 

分 类 号：R323.1[医药卫生—人体解剖和组织胚胎学] R651[医药卫生—基础医学]