蝶骨嵴锁孔入路的颅外解剖研究  

Extracranial anatomical study via sphenoid ridge keyhole approach

作　　者：张晖[1] 胡国汉[2,3] 廖建春 卢亦成[2,3] 

机构地区：[1]中国人民解放军空军总医院神经外科,北京100036 [2]中国人民解放军第二军医大学附属长征医院神经外科 [3]上海市神经外科研究所 [4]耳鼻咽喉科-头颈外科,上海200003

出　　处：《中国微侵袭神经外科杂志》2009年第11期507-509,共3页Chinese Journal of Minimally Invasive Neurosurgery

基　　金：中国人民解放军第二军医大学长征医院联合攻关课题(编号:2004002)

摘　　要：目的研究经蝶骨嵴锁孔入路的颅外解剖特点,探讨该入路的可行性及安全的切口长度。方法对14例(28侧)经10%甲醛溶液固定的尸头标本模拟蝶骨嵴锁孔入路,分别观察长度为4cm、5cm切口对颞浅动脉、面神经的损伤情况。结果切口为4cm时,颞浅动脉额支及面神经损伤的发生率分别为32.1%(9侧)及7.1%(2侧);切口为5cm时,损伤发生率则分别提高到82.1%(23侧)及42.9%(12侧)。所定翼点为一凹陷区,钻孔后证实为蝶骨嵴外侧端。结论蝶骨嵴锁孔入路手术切口为4cm左右时,对颞浅动脉、面神经损伤小,可显著降低损伤发生率,且能有效显露翼点,通过翼点钻孔可完成对外侧裂的有效显露。Objective To study the features of extracranial anatomy via sphenoid ridge keyhole approach, and explore feasibility of the approach and a safe incision length. Methods Fourteen adult cadaveric heads （28 sides） were fixed with 10% formalin and studied via simulated sphenoid ridge keyhole approach for understanding the injuries to the superficial temporal artery and facial nerve when the incision length was 4 cm and 5 cm, respectively. Results When the incision length was 4 cm, the injury rates of frontal branch of superior temporal artery and facial nerve were 32.1% （9 sides） and 7.1% （2 sides）, respectively, while the injury rates reached to 82.1% （23 sides） and 42.9% （12 sides） with a incision length of 5 cm. The pterion was a bony depression, and was located on the lateral end of sphenoid ridge through sphenoid ridge keyhole approach. Conclusion The injury to the superficial temporal artery and facial nerve is mildest when a 4 cm incision is taken, furthermore it also can effectively expose the pterion, and then effectively expose the sylvian fissure through hole drilled via the pterion.

关 键 词：锁孔入路 蝶骨嵴 神经解剖学 面神经损伤 颞浅动脉损伤 

分 类 号：R322[医药卫生—人体解剖和组织胚胎学]