经脑干腹侧至面神经脑桥小脑三角段的显微外科解剖  

Microsurgical anatomy of cerebellopontine angle segment of the facial nerve through ventral brainstem

作　　者：代飞虎 董吉荣 Dai Feihu;Dong Jirong(Wuxi Clinical College,Anhui Medical University;Department of Neurosurgery,PLA 101 Hospital,Wuxi 214000,China)

机构地区：[1]安徽医科大学无锡临床学院 [2]中国人民解放军第101医院神经外科,无锡214000

出　　处：《解剖学杂志》2018年第2期172-174,195,249,共4页Chinese Journal of Anatomy

摘　　要：目的:研究面神经脑桥小脑三角段与周围神经血管等结构的解剖关系,为显微血管减压术治疗面肌痉挛提供显微解剖参数。方法:成人头颅标本,经口咽至斜坡暴露脑干腹侧面,经脑干腹侧面对面神经脑桥小脑三角段及周围诸结构进行显微测量。结果:面神经与脑桥分离点至面神经实际出入脑干处、内耳门距离为(6.08±0.85)mm、(11.55±1.11)mm;前庭蜗神经与脑桥分离点至前庭蜗神经实际入脑干处、内耳门距离为(6.86±0.91)mm、(10.20±1.19)mm。面神经实际出入脑干处、面神经与脑桥分离点位于舌咽神经出入脑干处、前庭蜗神经与脑桥分离点、绒球内侧缘内侧,是面神经减压重要区域。面神经实际出入脑干处至舌咽神经出入脑干处、前庭蜗神经与脑桥分离点、绒球内侧缘距离分别为(2.12±0.44)mm、(6.32±0.76)mm、(5.65±0.99)mm。面神经与桥脑分离点至舌咽神经出入脑干处、前庭蜗神经与脑桥分离点、绒球内侧缘距分别为(5.95±0.70)mm、(1.18±0.53)mm、(2.98±0.73)mm。结论:面神经实际出入脑干处、面神经与脑桥分离点与血管压迫关系密切,空间位置较深,是术中减压和避免损伤的操作重点。舌咽神经、前庭蜗神经、绒球可作为术中快速定位面神经脑桥小脑三角段进行减压的重要标志。Objective:To study the anatomical relationship between cerebellopontine angle segment of facial nerve and surrounding neurovascular structures and to offer anatomic parameters for treating hemifacial spasm with microvascular decompression.Methods:Fifteen adult head specimens were exposed to the ventral surface of the brainstem through oropharynx to clivus.Microscopic measurements were made on the sections and structures around the cerebellopontine angle segments of the facial nerve.Results:The distance from root detachment point of facial nerve to root exit point of facial nerve,internal acoustic pore were(6.08±0.85)mm,(11.55±1.11)mm.The distance from root detachment point of vestibulocochlear nerve to root enter point of vestibulocochlear nerve,internal acoustic pore were(6.86±0.91)mm,(10.20±1.19)mm.The root exit point and root detachment point of facial nerve were important regions of decompression of facial nerve,which were located in the inner side of root exit point of glossopharyngeal nerve,root detachment point of vestibulocochlear nerve,inside edge of flocculus.The distance from root exit point of facial nerve to root exit point of glossopharyngeal nerve,root detachment point of vestibulocochlear nerve,inside edge of flocculus were(2.12±0.44)mm,(6.32±0.76)mm,(5.65±0.99)mm,respectively.The distance from root detachment point of facial nerve to root exit point of glossopharyngeal nerve,root detachment point of vestibulocochlear nerve,inside edge of flocculus were(5.95±0.70)mm,(1.18±0.53)mm,(2.98±0.73)mm,respectively.Conclusion:The root exit point of the facial nerve and the root detachment point of facial nerve are the focal point of decompression and can avoid the damage during operation for it closely related to the vascular compression and deep space.Glossopharyngeal nerve,vestibulocochlear nerve,and flocculus are important signs for fast positioning of cerebellopontine angle segment of facial nerve to decompression in the operation.

关 键 词：脑干腹侧 面神经 脑桥小脑三角段 显微外科解剖 

分 类 号：R322.81[医药卫生—人体解剖和组织胚胎学]