颞下入路的显微解剖学研究  

Study of Anatomy Related to Microsurgery through Subtemporal Approach

作　　者：张力[1] 涂汉军[1] 朱志华[1] 李新建[1] 陈晟[1] 秦军[1] 黄宽明[1] 王辉[1] 

机构地区：[1]郧阳医学院附属太和医院神经外科,湖北十堰442000

出　　处：《中国临床神经外科杂志》2008年第1期20-22,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：目的研究颞下入路中小脑幕中切迹间隙的解剖结构,指导临床手术入路的选择。方法在手术显微镜下模拟颞下入路对10例经甲醛溶液固定的国人成人尸头标本进行逐层解剖,并观察、测量重要神经解剖结构之间的关系,描述颞下手术入路所暴露的视野范围,然后切开小脑幕,观察增加的暴露范围。结果颧弓至脑干和小脑幕游离缘的最短距离分别为(46.83±3.52)mm和(39.00±2.65)mm;天幕游离缘与滑车神经、小脑上动脉、大脑后动脉和三叉神经后根的距离分别为(1.90±0.55)mm、(5.12±2.20)mm、(3.28±1.67)mm、(0.80±0.20)mm。结论颞下入路手术治疗小脑幕中切迹间隙病变具有手术操作距离短、垂直视角大、对中切迹间隙的暴露范围广泛等优点。Objective To observe and measure the anatomical structure related to micrusurgery through the subtemporal approach to the middle incisural space. Methods Ten specimens of formalin-fixed cadaveric heads were dissected by simulating the subtemporal approach. The relationship among the targeted neurovascular structures was observed and measured, and the extent of exposure by this approach was described. Results The shortest distances from the zygomatic arch to the brain stem and the edge of tentorium incisura were （46.83±3.52）mm and （39.00±2.65）mm respectively. The distances from the edge of tentorium incisura to the trochlear nerve, the superior cerebellar artery, the posterior cerebral artery and the trigeminal ganglion were （1.90±0.55）mm, （5.12±2.20）mm, （3.28±1.67）mm and （0.80±0.20）mm respectively. A wider scope of expoure was obtained by cutting the tentorium. Conclusions The subtemporal approach has advantages such as shorter distance of operation, bigger straight visual angle,wider visual field and more simple maneuver.

关 键 词：颞下入路 小脑幕 解剖学研究 

分 类 号：R322.81[医药卫生—人体解剖和组织胚胎学]