经海绵窦脑神经的显微外科解剖及其临床意义  

Microsurgical anatomical study on cranial nerves via cavernous sinus and its clinical significance

作　　者：尹嘉[1] 曹瑞华[2] 丁学华[1] 廖建春[3] 张光霁[1] 楼美清[1] 骆纯[1] 卢亦成[1] 

机构地区：[1]第二军医大学长征医院神经外科,上海200003 [2]第二军医大学长征医院皮肤科,上海200003 [3]第二军医大学长征医院耳鼻咽喉科,上海200003

出　　处：《中国临床解剖学杂志》2002年第6期421-423,共3页Chinese Journal of Clinical Anatomy

摘　　要：目的 :了解与海绵窦相关的脑神经走行及其周围结构的显微解剖关系 ,为经该区的直接显微手术提供依据。方法 :用 30例成人头颅标本 ,在手术显微镜下对海绵窦内脑神经 (CN)及周围结构直接进行解剖观察和测量。结果 :经海绵窦的脑神经在后面大多在外侧壁 ,较易分辨 ,Parkinson切口前限可从动眼神经入口平面延长到前床突 (ACP)尖平面。脑神经向前则行走于ACP下缘 ,经床突间隙 (CS)入路磨除ACP时极易损伤 ,其中以动眼神经和滑车神经距离最近 ,在ACP根部 ,动眼神经和滑车神经均紧贴ACP根部底层硬膜入眶 ,距离分别只有 (0 .64± 0 .2 2 )mm (0 .2 6～ 1 .0 8mm)和 (0 .55± 0 .0 6)mm (0 .1 6～ 0 .96mm)。结论 :为途经海绵窦外侧壁手术入路和经CS手术磨除ACP时避免损伤脑神经提供了显微解剖学资料。Objective: To provide anatomical basis for direct microsurgical operation of cranial nerves (CN) via cavernous sinus and sellar area by observing the microanatomical relationship of these structures. Methods: Thirty adult cadaveric head specimens were dissected in detail under operating microscope. Results: Most posterior part of CN via cavernous sinus was located in the lateral wall and was easy to be distinguished. The Parkinson incision can be extend forward further. The CN went ahead continuously below the anterior clinoid process(ACP). The CN can be injured easily during drilling the ACP via clinoid space(CS) approach. The distances from the oculomotor nerve and trochlear nerve to ACP were smallest which were 0.64±0.22 (0.26～1.08)mm and 0.55±0.06 (0.16～0.96)mm respectively. Conclusion: The above data are useful to microsurgical operation of CN.

关 键 词：脑神经 海绵窦 床突间隙 显微解剖学 

分 类 号：R323.1[医药卫生—人体解剖和组织胚胎学]