颈内静脉减压治疗脑鸣手术入路的显微解剖学研究  

Anatomical study of surgical approaches for treating brain tinnitus by decompression of the internal jugular vein

作　　者：毛贝贝 朱广通 肖智勇 黄辉 关峰 胡志强 吉训明 Mao Beibei;Zhu Guangtong;Xiao Zhiyong;Huang Hui;Guan Feng;Hu Zhiqiang;Ji Xunming(Department of Neurosurgery,Beijing Shijitan Hospital Affiliated to Capital Medical University,Beijing 100038,China;Capital Medical University Brain Research Center,Beijing Institute of Brain Disorders,Beijing 100069,China)

机构地区：[1]首都医科大学附属北京世纪坛医院神经外科,北京100038 [2]首都医科大学脑重大疾病研究中心,北京脑重大疾病研究院,北京100069

出　　处：《中华神经外科杂志》2024年第8期837-840,共4页Chinese Journal of Neurosurgery

摘　　要：目的通过显微解剖研究颈内静脉减压手术入路中所涉及的重要解剖学结构,明确寰椎横突与周围结构的空间定位关系,为行颈内静脉减压手术治疗脑鸣提供解剖学依据。方法选取成人尸头标本3例(共6侧),在手术显微镜下以寰椎横突为参照中心对周围结构进行逐层解剖及显微观察,明确周围解剖结构的形态及相互关系。结果充分显露胸锁乳突肌、二腹肌后腹,以寰椎横突作为标志,可定位颈内动脉、颈内静脉和颈部上部的副神经。显露外侧颅底及乳突,可见寰椎横突与周围的肌肉、骨骼、血管和神经的解剖关系相对固定。结论寰椎横突可作为颈内静脉减压手术中重要的解剖标志,熟悉并掌握寰椎横突与周围结构的关系有助于临床医生准确识别并保护周围的重要组织结构。Objective To elucidate the important anatomical structures involved in the surgical approach of internal jugular vein decompression through microscopic anatomy research,to clarify the spatial relationship between the transverse process of the atlas vertebra(C 1)and surrounding structures,and to provide anatomical evidence for performing internal jugular vein decompression surgery for the treatment of pulsatile tinnitus.Methods Three adult cadaveric head specimens(6 sides in total)were selected.Under the surgical microscope,the surrounding structures were dissected and microscopically observed with the transverse process of the atlas vertebra as the central reference point to determine the morphology and relationships of the surrounding anatomical structures.Results The study revealed the clear exposure of the sternocleidomastoid muscle,posterior belly of the digastric muscle,and identification of the internal carotid artery,internal jugular vein,and accessory nerve of the upper neck using the transverse process of the atlas vertebra as a landmark.The exposure of the lateral skull base and mastoid process showed relatively fixed anatomical relationships between the transverse process of the atlas vertebra and surrounding muscles,bones,vessels,and nerves.Conclusions The transverse process of the atlas vertebra can serve as an important anatomical landmark in internal jugular vein decompression surgery.Familiarity with and understanding of the relationship between the transverse process of the atlas vertebra and surrounding structures can assist clinicians in accurate identification and protection of surrounding vital tissue structures during surgery.

关 键 词：尸体解剖 颈寰椎 减压术 外科 副神经 颈静脉 

分 类 号：R651.1[医药卫生—外科学]