颈静脉孔区静脉窦开口的解剖学研究  

An Anatomical Study of Openings of Venous Sinuses in Jugular Foramen

作　　者：孙慧颖 高志强 田旭 赵杨 魏兴梅 奥登苏日塔 于姝婷 宋雯洁 冯国栋 SUN Huiying;GAO Zhiqiang;TIAN Xu;ZHAO Yang;WEI Xingmei;AO Dengsurita;YU Shuting;SONG Wenjie;FENG Guodong(Department of Otorhinolaryngology,Peking Union Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医学院北京协和医院耳鼻咽喉头颈外科

出　　处：《中华耳科学杂志》2019年第3期296-299,共4页Chinese Journal of Otology

基　　金：“十二五”国家科技支撑计划重点项目(2012BAIl2B01)~~

摘　　要：目的探讨颈静脉孔区静脉窦开口的特点及与神经的毗邻关系。方法统计分析30例颅骨标本中颈静脉球及近颈静脉球的乙状窦、颈内静脉内静脉窦开口的位置、数量、最长径及其与颅神经的关系。结果全部标本均可观察到岩下窦开口,60%(18/30)为多个开口,90%(27/30)有一较大开口位于颈静脉球前内侧壁,且与第IX、X、XI颅神经关系密切。60%(18/30)标本中可见后髁导静脉的开口,94.4%(17/18)为单个开口,常位于颈静脉球底壁或静脉球与乙状窦交界处。颈静脉球内侧壁可见数量不等的边缘窦、枕窦及岩骨穿支静脉的开口。结论颈静脉球及近颈静脉球的乙状窦、颈内静脉内存在多个静脉窦的开口,行此区手术时应充分止血并仔细检查各个开口,避免肿瘤残留,处理前内侧岩下窦开口时应轻柔操作,避免损伤后组颅神经(IX、X、XI)。Objective To study the anatomical characteristics of venous sinuses openings and their relationship with cranial nerves in the jugular foramen. Methods The location, number and longest diameter of venous sinuses openings in the jugular foramen were measured in 30 temporal bones specimens. The relationship between venous sinuses openings and cranial nerves was examined. Results 60%(18/30)of inferior petrosal sinus(IPS) had several openings.90%(27/30)of IPS had the largest branch going between cranial nerves with an opening in the anteromedial wall of jugular bulb(JB). 60%(18/30) of specimens had opening of posterior condylar emissary vein(PCEV). 94.4%(17/18) of PCEV had one large opening on the floor of JB or the junction of sigmoid sinus and JB. There were several openings of marginal sinus(MS), occipital sinus(OS) or perforating branches of veins going through petrosal bone. Conclusion The venous sinuses may have several openings in the jugular foramen, requiring carefully examination for residual tumor and adequate hemostasis. Care must be taken in the management of the IPS anteromedial branch to avoid damaging the cranial nerves.

关 键 词：颈静脉孔 静脉窦 颅神经 

分 类 号：R764[医药卫生—耳鼻咽喉科]