高颈位手术入路中寰椎横突的解剖学意义

目的 研究寰椎横突(TPA)在高颈位手术入路中的临床解剖学意义.方法 成人尸头标本20例,在手术显微镜下以TPA为参照中心对高颈部进行显微解剖.结果 在确定TPA位置之后以之为中心,高颈部的所有重要结构均可有条理地识别.TPA浅面有二腹肌后腹.茎突位于其前方,颈内静脉和后组颅神经位于茎突和TPA之间.沿颈动脉鞘向上可至颈动脉管和颈静脉孔(JF).JF的前下方,舌下神经通过舌下神经管出颅.TPA后部为枕下三角,三角内可见椎动脉及静脉丛.结论 TPA在高颈位手术入路中是一个恒定而又可靠的解剖学标记,可通过其切除病变同时识别并保护相关的重要组织结构,减少并发症的发生.

Transverse process of atlas:clinical anatomy implication in the high cervical approach

Objective To investigate the Clinical anatomy implication of the transverse process of the atlas(TSA)in the high cervical approach.Methods Under a surgical microscope,twenty cadaver heads were used to study the microsurgical anatomy of high cervical part with the help of the TPA.Results The TPA was located and marked as a reference center,all the important structures in the high cervical part could be identified systematically.Lateral to the TPA sits the posterior belly of the digastric muscle,anterior to the TPA,the styloid process can be exposed.The internal jugular vein and cranial nerves Ⅹ、Ⅺ、and Ⅻsit between the styloid process and the TPA.Superior to the TPA,tracing the carotid sheath upward,the carotid canal and jugular foramen could be reached.Anteroinferior to the jugular foramen,the hypoglossal nerve emerges from the cranial cavity through the hypoglossal canal.Posterior to the TPA,the suboccipital triangle can be recognized.Within the triangle,the vertebral artery and its accompanying venous complex can be identified.Conclusion The TPA is a constant and reliable surgical landmark in the high cervical approach.Besides removing growthes,we can identify and protect relative important structures to reduce the postoperative complications with the aid of the TPA.