鞍侧腔外侧壁手术切开的应用解剖学研究

目的为经鞍侧腔(LSC)外侧壁手术切开提供解剖学基础。方法对15例(30侧)成人头颅标本的LSC外侧壁进行解剖观测。结果①硬膜内途径沿前岩床皱襞分离LSC外侧壁脑膜时却可将LSC外侧壁明确的分为3层;②动眼神经鞘膜袋前部深(4.69±1.31)mm,后部深(6.50±1.58)mm;③滑车神经LSC段可分为4型:近眼神经型30%(9侧)、近动眼神经型33.3%(10侧)、"S"型10%(3侧)、直型26.7%(8侧)。结论熟悉LSC外侧壁膜层次、动眼神经鞘膜袋及滑车神经走行特点,有助于减少或避免LSC外侧壁手术切开的并发症,有助于扩大手术显露。

Applied anatomic study on the operative incision of the lateral wall of the lateral sellar compartment

Objective To provide anatomic basis for the operative incision of the lateral wall of the lateral sellar compartment(LSC).Methods The structures of the lateral wall of LSC were dissected,observed and measured on 30 sides from 15 cadaveric heads.Results The lateral wall of the LSC could be clearly divided into three layers,when it was dissected via the intradural approach to LSC along the anterior petroclinoid fold.The leptomeningeal pockets of the oculomotor nerve,the depth in the anterior was(4.69±1.31) mm,in the posterior was(6.50±1.58) mm.According to the course of trochlear nerve on the lateral wall of LSC,could be classified four types,found the type of the trochlear nerve near the ophthalmic nerve in 30%(9 samples),the type of the trochlear nerve near the oculomotor nerve in 33.3%(10 samples),"s" type in 10%(3 samples),straight type in 26.7%(8 samples).Conclusion Understand the three layers of the lateral wall of the LSC,the leptomeningeal pockets of the oculomotor nerve and the different types of the course of trochlear nerve on the lateral wall of LSC,may conduce to decrease or avoid the unnecessary injure of the operative incision and enlarge the intraoperative exposure.