桥脑延髓沟的显微解剖学研究  

Microanatomy of pontomedullary sulcus

作　　者：张继志[1] 段云平[1] 高宝山[1] 

机构地区：[1]大连大学附属中山医院神经外科,116001

出　　处：《中国现代药物应用》2009年第13期6-8,共3页Chinese Journal of Modern Drug Application

摘　　要：目的微血管减压术手术成功的关键是基于对面神经出脑桥区域即桥延沟解剖的精确掌握。我们研究桥延沟显微解剖。方法来自于15个大脑标本的30个桥小脑角部分显微镜下观察。结果将面神经根出桥脑区域分作两部分,一部分称为周围部,另一部分称为脑干部。而后者我们又提出分为两部分,分别为基底部和斜坡部。对周围部的暴露相对容易,而脑干部分因被舌咽神经和迷走神经所掩盖,故解剖困难。结论由尸检标本,桥延沟的解剖是面神经微血管减压术中的重点,在治疗一侧面肌痉挛中作用重大。Objective Microvascular decompression is an effective treatment for hemifacial spasm. A complete performance of this surgery is based on the precise comprehension of the anatomy of this area around the facial never, s root exit zone. In this study we report the importance of the pontomedullary sulcus in this sur- gery. Methods 30 cerebellopontine angle from 15 autopsied brain were inspected under the operative microscope. Illustrative operated 400 cases that show the importance of the pontomeduuary sulcus were presented. Result The facial nerver, s root exit zone is divided into two parts：one is peripheral part and another is brain stem part. Moreover the brain steml part is derided into two parts. One is basal part and another is sloping part Clinically it, s easier to decompress the peripheral part. However brain stem part is hidden by the glossopharyngeal and vagus nevers ,it may be overlooked . Some offensive vessels are located and hidden in this area. To avoiding the overlooking of the brain stem part, we should inspect the pontomedullary sulcus and should cut the arachnoid membrane fully around the roots of the glossopharyngeal and vagus nerves. Conclusion From the finding of the autopsied brain and the surgery, the area of pontomeduUary sulcus is the key in microvascullar decorn-pression and is important in the treatment for hemifacial spasm.

关 键 词：面肌痉挛 微血管减压 桥延沟 

分 类 号：R651[医药卫生—外科学] R322[医药卫生—临床医学]