前入路的斜坡侧壁显微解剖研究与临床应用  

Microanatomic study of the lateral structures of clivus for anterior approach and its clinical application

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：《中华神经外科疾病研究杂志》2003年第2期129-132,共4页Chinese Journal of Neurosurgical Disease Research

摘　　要：目的　为前方经斜坡入路提供斜坡侧壁重要结构的显微解剖参数和显露方法。方法　对2 0具成人头颅标本 ,仿Janecka的标准面部移位入路切口 (左侧 )行两侧斜坡侧壁结构显微解剖观察和测量 ,并初步探讨颞肌瓣转移重建斜坡硬膜的可行性。结果　上斜坡侧壁主要结构有视神经管隆起和颈内动脉隆起 ;中斜坡侧壁重要结构有颈内动脉岩骨段、岩下窦和外展神经经过的Dorello管 ,循翼管向后方可安全确认颈内动脉岩骨段 ;下斜坡侧壁首要结构为椎动脉和后组颅神经。颞肌瓣转移可有助于斜坡硬膜重建。结论　掌握斜坡侧壁的显微解剖和重要结构的显露方法 ,有助于经斜坡入路的侧方扩展。Objective To provide microsurgical anatomic parameters of the lateral structures of clivus and exposure methods for anterior transclival approach. Methods Twenty adult cadaveric heads fixed with formol were employed for the purpose of this study. The microsurgical dissection and measurement had been performed under microscope by mimicking anterior transclival approach, meanwhile, the feasibility of temporalis muscle flap transfer for the reconstruction of clival meninges was examined. Results The lateral structures of upper clivus consisted of the prominence of optic canal and the prominence of internal carotid artery; and the lateral structures of middle clivus were composed of petrous internal carotid artery, inferior petrous sinus and abducent nerve; and the lateral structures of lower clivus comprised vertebral artery and posterior cranial nerves.Temporal muscle flap transfer facilitated the reconstruction of clival meninges. Conclusion To master the microsurgical anatomy of the lateral structures of clivus was beneficial to expanding lateral exposure in anterior transclival approach , and temporal muscle flap transfer was possible to reconstruct the clival meninges.

关 键 词：前入路 斜坡侧壁 显微解剖 临床应用 

分 类 号：R651.11[医药卫生—外科学]