颈静脉球内侧壁的临床解剖研究  

Applied anatomy of medial wall of the glomus jugulare

作　　者：田广永[1] 段永畅[1] 石小田[2] 于巧莲[1] 彭志强[3] 黄美贤[4] 徐达传[4] 

机构地区：[1]南方医科大学第三附属医院耳鼻咽喉头颈外科,广州510630 [2]海南医学院解剖教研室,海口571100 [3]广州市番禺区中医院神经外科,511400 [4]南方医科大学解剖学教研室,广州510515

出　　处：《中华神经医学杂志》2011年第8期801-804,共4页Chinese Journal of Neuromedicine

基　　金：广东省自然科学基金（A20103501

摘　　要：目的探讨颈静脉球内侧壁的解剖学特点，为颈静脉球部位的外科手术提供理论指导。方法显微镜下解剖15具经福尔马林固定乳胶灌注的成人头颅标本颈静脉球部位．观察颈静脉球内侧壁部位的结构特点及神经走行关系；在5具干颅骨标本上观察颈静脉球内侧壁的骨性标志。结果颈静脉孔内口、颞骨颈静脉突、枕骨颈静脉突、硬脑膜及经该部位穿行的Ⅸ、Ⅹ、Ⅺ颅神经共同构成了颈静脉球内侧壁；在颈静脉球内侧壁白前上往后下做一弧形斜线，斜线的前下位置为神经部，为神经纤维束穿行部位；后上部位为静脉部位，颈静脉球壁与颞骨岩部及硬脑膜紧贴；舌咽神经走行在前上位置，多数有岩下窦的开口将之与迷走神经分隔，中间有条索状的纤维组织分隔。迷走神经和副神经在颈静脉球内侧壁走行关系密切，本组有26侧（86．67％）舌咽神经与迷走神经之间有硬脑膜间隔，4侧（13．33％）硬脑膜间隔不明显。迷走神经和副神经无明显间隔穿人颈静脉球内侧壁，多数迷走神经与副神经容易区分；舌下神经经舌下神经管走行在颈静脉球内侧壁的下方。结论颈静脉孔内口、颞骨岩部的部分骨质、枕骨的部分骨质、后组颅神经、硬脑膜及静脉壁共同组成颈静脉球的内侧壁，了解该部位的解剖学特点能够对颈静脉球部位手术提供理论指导，减少手术并发症。Objective To study the anatomical features of medial wall of the glomusjugulare to provide the theoretical direction for surgery of the glomus jugulare. Methods Fifteen （30 sides） formalin-fixed adult cadaveric specimens were dissected under the operating microscope, and their structural features of the medial wall of the glomus jugulare and their anastomosis of nerves were observed; and 5 dry skull specimen were also employed to observe the bone landmark of medial wall of the glomus jugulare. Results The medial wall of the glomus jugulare is composed of endocranial opening of the jugular foramen, jugular process of the temporal bone and occipital bone, cerebral dura mater and the IX, X and XI cranial nerves. A curve line was marked on medial wall of the glomus jugulare, finding that the cranial nerves and the cerebral dura mater are at the anteroinferior position and the posterior-up part is composed of the well of the jugular vein adhered to the petrous bone and cerebral dura mater. Cranial nerve IX travels at the anterosuperior part of its own fibrous sheath and the inferior petrosal sinus ostium separates it fi＇om cranial nerves X and XI; cerebral dura mater separates the cranial nerves IX and X. The cranial nerve X and the accessory nerve are closely related. Interval of cerebral dura mater between cranial nerve IX and X is clearly seen in 86.67% （26/30） patients and illegible in 13.33% （4/30）. Hypoglossal canal travels of the bottom of the medial wall of the glomus jugulare. Conclusion The medial wall of the glomus jugulare is composed of endocranial opening of the jugular foramen, jugular process of the temporal bone and occipital bone, cerebral dura mater and the IX, X and XI cranial nerves, and this information can help the clinicians during the operations of the jugulare foramen, so that the operation complications can be reduced.

关 键 词：颈静脉球 颅神经:应用解剖 

分 类 号：R323.1[医药卫生—人体解剖和组织胚胎学]