经口咽入路治疗颅颈区腹侧畸形的解剖及临床研究  

Transoral Approach for the Treatment of Ventral Malformation of Craniocervical Junction:microsurgical anatomy and clinical application

作　　者：陈晓雷[1] 刘宁[1] 朱风仪[1] 赵春生[1] 周明卫[1] 骆慧[1] 

机构地区：[1]南京医科大学第一附属医院神经外科,江苏南京210029

出　　处：《南京医科大学学报（自然科学版）》2008年第5期673-676,共4页Journal of Nanjing Medical University(Natural Sciences)

基　　金：卫生部自然科学基金(WKJ2004-2-010)

摘　　要：目的:探讨经口咽入路显微手术治疗颅颈交界区腹侧畸形的要点,并对相应的显微解剖学基础加以讨论。方法:选用福尔马林固定的成人尸头标本15例进行解剖学观察;并应用该入路治疗颅颈交界区腹侧畸形16例,对其临床资料进行回顾性总结。结果:经口咽入路手术可以达到斜坡下部至颈3椎体上缘,双侧椎动脉到中线的距离C1,2水平约20.1mm,C2,3水平约16.2mm;16例患者中痊愈11例,好转4例,无效1例,手术并发症包括1例脑脊液漏,1例严重的舌肿胀,无死亡病例。结论:经口咽入路显微手术具有手术径路短,创伤小、并发症少的优点,是治疗颅颈交界区腹侧畸形的首选方法。Objective：To explore the key point of microsurgical treatment of ventral malformation of craniocervical junction and discuss the anatomic foundation of microsurgical methods. Methods：The anatomy structures were observed and measured in 15 cadveric heads. The clinical data of 16 consecutive patients with ventral malformation of craniocervical junction operated upon through transoral approach,from September 2003 to June 2007,were reviewed retrospectively. Results：The operative exposure in transoral approach ranged from lower clivus to the superior part of the C3 vertebral body. The distance from the vertebral artery to the midline：20.1 mm at the level of C12, 16.2 mm at the level of C23. Among the 16 patients,there was good recovery in ll,improvement in 4,and no changes in 1. The complications included cerebral-spinal fluid leakage in 1 case and severe swell of the tongue in 1 case. There was no operative mortality in call cases. Conelusion：Transoral mirosurgical decompression is the first selection of treatment for ventral malformation of craniocervical junction, with short distance, alleviative operative trauma and few complications.

关 键 词：口咽入路 显微手术 畸形 颅颈交界区 

分 类 号：R653[医药卫生—外科学]