Le FortⅠ截骨入路至斜坡的应用解剖  

Anatomic study of Le Fort Ⅰ osteotomy approach to clivus

作　　者：徐进[1] 刘宁[2] 朱风仪[2] 邢光前[1] 尹林[3] 徐其昌[1] 

机构地区：[1]南京医科大学第一附属医院耳鼻喉科,南京210029 [2]南京医科大学第一附属医院神经外科,南京210029 [3]南京医科大学第一附属医院颌面外科,南京210029

出　　处：《解剖学研究》2003年第4期249-250,260,共3页Anatomy Research

基　　金：江苏省科技厅社会发展重点资助 (BS2 0 0 0 0 5 0 )

摘　　要：目的　为LeFortⅠ截骨入路切除斜坡区病变的临床应用提供解剖学基础。方法　随机选取经福尔马林保存的成人尸头 1 5具 ,用显微解剖技术对LeFortⅠ截骨入路从显露范围、安全程度、美容效果三方面进行评价。结果　斜坡区与脑桥、延髓腹侧及第Ⅴ～Ⅻ对脑神经关系密切 ,两侧毗邻破裂孔、颈内动脉、内耳门及颈静脉孔。颈内动脉管外口、破裂孔、颈静脉孔距中线最小间距分别为 2 2 9、8 4和 1 9 5mm。LeFortⅠ截骨入路与前方、侧方入路相比 ,具有手术野开阔、手术操作安全性高、对斜坡区显露良好 ,面部无瘢痕的优点。结论　了解斜破区各结构的形态及相互间的毗邻关系 ,可提高该区相关手术时的安全度和成功率 ,LeFortⅠ截骨入路可作为斜坡及其周围区域病变手术的一种良好选择 ,值得推广。Objective To provide an advisable anatomic reference for Le Fort Ⅰ osteotomy approach. Methods Le Fort Ⅰ osteotomy approach was imitated on 15 randomly formalin preserved adult heads, and was evaluated from respects of exposing effect, traumatic extent, and cosmetic result. Results Clival region had closing relationship to pons, ventral medulla oblongata and the Ⅴ～Ⅻ cranial nerves. In the two sides of clival region, there were foramen lacerum, carotid canal, internal acoustic port, jugular foramen. The smallest distance to middle line of foramen lacerum, carotid canal and jugular foramen were 22 9, 8 4 and 19 5 mm respectively. Le Fort Ⅰ osteotomy has distinct advantages over traditional anterior or lateral approaches, including a more direct line of vision,improved exposure,lower traumatic extent and cosmesis. Conclusion Knowing the relationship of shape and position between the clival region and it′s environment is favorable for preserving the important structures in clival region.

关 键 词：LE FortⅠ截骨术 手术入路 应用解剖学 安全性 斜坡区病变 

分 类 号：R322[医药卫生—人体解剖和组织胚胎学]