蝶窦外侧壁和海绵窦内侧面观显微解剖研究  

Microanatomic study of the lateral walls of sphenoid sinus and the medially-viewed cavernous sinus

作　　者：黄安炀[1] 刘运生[1] 王延金[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：《中国微侵袭神经外科杂志》2003年第1期25-28,共4页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的为扩大经蝶手术和前方颅下手术提供蝶窦外侧壁和海绵窦内侧面观显微解剖参数。方法对20具成人头颅标本,仿Janecka的标准面部移位入路切口(左侧)行两侧蝶窦外侧壁和海绵窦内侧面观显微解剖观察和测量。结果蝶窦外侧壁的主要结构有视神经管隆起和颈内动脉隆起,而颈内动脉隆起缺失的出现率高达50%,此时,依照翼管-破裂孔-颈内动脉破裂孔段途径显露颈内动脉海绵窦段为一安全策略。内移颈内动脉海绵窦段,可以充分显露海绵窦外侧壁的颅神经。结论掌握蝶窦外侧壁显微解剖和从内侧面显露、移动颈内动脉海绵窦段,有助于扩大经蝶手术和前方颅下手术对病变累及海绵窦的处理。Objective To provide microanatomic parameters of the lateral walls of the sphenoid sinus and the medially-viewed cavernous sinus for extended transsph enoidal surgery and anterior subcranial surgery. Methods Twenty adult cadaveric heads fixed with formalin were examined for this study. The microsurgical dissec tion and measurement had been performed under microscope through Janecka's stand ard facial translocation incision. Results The lateral walls of sphenoid sinus m ainly consisted of the prominence of optic canal and the prominence of ICA, and the abscence of prominence of ICA was common. In this setting the course of the pterygoid canal-lacerum foramen-the lacerous ICA was a safe astrategy to locate the cavernous ICA. With the medial mobilization of cavernous ICA, the lateral wa ll of cavernous sinus was fully exposed. Conclusions To master the microsurgical anatomy of the later walls of sphenoid sinus and the medial mobilization of cav ernous ICA, it was useful for extended transsphenoidal surgery and the anterior subcranial surgery.

关 键 词：蝶窦 海绵窦 显微解剖 颈内动脉 

分 类 号：R322[医药卫生—人体解剖和组织胚胎学]