颈静脉孔的显微外科解剖学研究  

Microsurgical anatomy of the jugular foramen

作　　者：黄军[1] 袁贤瑞[1] 奚健[1] 丁锡平[1] 姜维喜[1] 刘景平[1] 

机构地区：[1]中南大学湘雅医院神经外科,湖南长沙410008

出　　处：《中国临床解剖学杂志》2002年第2期103-105,共3页Chinese Journal of Clinical Anatomy

摘　　要：目的:为颈静脉孔区病变的手术提供显微外科解剖学基础。方法:在手术显微镜下对２０例福尔马林固定的成人头颈部标本和１０例成人颅骨标本的颈静脉孔区进行显微解剖和观测。结果:静脉孔分成三部,即神经部、岩部、乙状部,岩部为接收岩下窦、舌下神经管静脉、岩斜裂静脉和椎静脉丛分支的静脉窦;乙状部接收乙状窦血流;神经部由位于结缔组织鞘中的舌咽、迷走、副神经所组成。颈静脉孔长(１３．４±１．１)ｍｍ,颈静脉孔乙状部宽(９．１±１．９)ｍｍ,颈静脉孔的乙状部高(７．３±２．２)ｍｍ,颈静脉孔的内、外口相距(１２．７±１．５)ｍｍ。颈静脉球具有下述特点:(１)静脉壁相当薄,不及乙状窦及颈内静脉壁一半的厚度 ;(２)连接多处的引流静脉;(３)完全位于骨质中且位置变异较大;(４)邻近重要结构等。高位颈静脉球出现率为１５%。结论:熟悉颈静脉孔区的显微解剖有利于手术中保护重要的神经和血管。Objective: To provide the microanatomical basis for surgical treatment of lesions related to jugular forament Methods: The jugular foramen were observed and measured under the surgical microscope on 20 adult cadaveric head specimens fixed in formalin and 10 adult skull specimens.Results: The jugular foramen was divided into three compartments: the sigmoid part, the petrosal part and the neural part. The latter was located between the sigmoid and petrosal parts, and the glossopharyngeal, vagus and accessory nerves passed throuhg it. The length of jugular foramen was 13.4±1.1 mm; the width of sigmoid part was 9.1 ± 1.9 mm; height of sigmoid part was 7. 3 ± 2. 2 mm; the distance between the exocranial and endocranial of jugular forament was 12. 7 ± 1.5 mm. The jugular bulb received drainages from both intracanial and extracranial source was housed in the jugular fossa, and it had a very thin wall. There were three high jugular bulbs in 20 sides of cadaver head specimens. Conclusion: The vital nerves and vascular structures can be protected in operation if we are familiar with the microsurgical anatomy of the jugular foramen.

关 键 词：显微外科解剖 颈静脉孔 颈静脉球 

分 类 号：R616.2[医药卫生—外科学] R654.3[医药卫生—临床医学]