颞骨岩部入路颅底手术有关的应用解剖  

Applied anatomy of cranial base operation through petrous pyramid approach

作　　者：李开荣[1] 兰永树[2] 吕亚萍[3] 胡兴宇[1] 

机构地区：[1]泸州医学院解剖学教研室 [2]泸州医学院附属医院放射科,四川泸州646000 [3]柳州市柳铁中心医院放射科,广西柳州545007

出　　处：《中国临床解剖学杂志》2009年第4期387-389,共3页Chinese Journal of Clinical Anatomy

摘　　要：目的:为经岩部入路颅底手术提供解剖学参数。方法:观测成人的100例干燥整颅、20例颅底标本、15例尸头及36侧正常颅底CT资料;观测项目为与经岩部入路颅底手术有关的颞骨表面标志与岩部内重要结构的位置及其间距。结果:整颅及颅底内面各项测量结果左右侧比较U均<1.96,P均>0.05,颞骨内重要结构间及与表面标志间距离测量结果多数项目男女性间比较U均>1.96或>2.58,P<0.05或<0.01;颅中窝入路可以弓状隆起作标志寻认上骨半规管以确认内耳道,也可以岩大神经管裂孔为标志暴露面神经膝状神经节与迷路段确认内耳道底;磨除岩尖部骨质时可以颈动脉管后壁与内耳门内侧缘的连线作为界线。结论:颞骨表面标志点间距及颞骨岩部内重要结构间的位置关系可为经岩部入路颅底手术提供重要参考,有利于术中岩部重要结构的定位与保护。Objective： To supply anatomic parameters for cranial base operation through petrous pyramid approach. Methods： Surface markers of temporal bone, the location and distribution of the important structures inside petrous pyramid concerning with cranial base operation were observed, measured and compared on 100 dry adult skulls, 20 cranial base samples, 15 cadaveric heads and 36 sides of CT films of normal adults. Results： The distances among superficial temporal bone markers helped to identify the location of sigmoid sinus and its upper and lower portions and the area of mastoid process that can be stripped during operation. The distances from posterior bony semicircular canal to anterior border of sigmoid sinus, from the labyrinth to facial nerve, from internal carotid artery to superficial markers on the petrous pyramid were helpful to identify and protect the labyrinth, facial nerve and internal carotid artery. When conducting operation through middle cranial fossa, the arcuate eminence can be taken as a marker for identifying upper bony semicircular canal while internal acoustic meatus and the hiatus of greater petrous nerve as a marker for unmasking of geniculate ganglion, the labyrinth and the fundus of internal acoustic meatus. When stripping substantial ossea of petrous pyramid, the line from posterior wall of carotid canal to posterior border of internal acoustic pore was the terminal line. Conclusions： The distances among superficial temporal bone markers and the location of important structures inside petrous pyramid may supply important references for cranial base operation through petrous pyramid approach.

关 键 词：颅底 颞骨 颞骨岩部 手术入路 应用解剖 

分 类 号：R323.1[医药卫生—人体解剖和组织胚胎学]