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颞下经岩骨前部手术入路的解剖学研究
引用本文:张喜安,钟世镇,漆松涛,黄胜平,潘军. 颞下经岩骨前部手术入路的解剖学研究[J]. 中国耳鼻咽喉颅底外科杂志, 2003, 9(2): 65-67,T001
作者姓名:张喜安  钟世镇  漆松涛  黄胜平  潘军
作者单位:1. 第一军医大学南方医院神经外科,广东,广州,510515
2. 第一军医大学临床解剖学研究所,广东,广州,510515
摘    要:目的:研究颞下经岩骨前部入路(Kawase入路)的解剖特点。方法:10例20例成人尸头标本在手术显微镜下进行显微解剖和测量。结果:岩骨前部切除后可暴露位于前外例的颈内动脉管水平段,以及颈内动脉管和内听道之间的耳蜗基底转。岩骨前部切除可分别在岩尖上面和内侧面开出面积为2.6cm^2和1.9cm^2的骨窗。与颞下经小脑幕入路相比,暴露范围在斜坡面向下扩大至斜坡上部、在脑干面扩大至椎基底动脉连接部和桥延沟水平。此入路暴露的岩斜坡区硬脑膜主要由脑膜垂体干和咽升动脉供血。结论:Kawase入路可同时暴露中后颅窝,其对后颅窝的暴露范围局限于岩斜坡区上半部。

关 键 词:颞下经 岩骨前部手术入路 解剖学 研究 Kawase入路
文章编号:1007-1520(2003)02-0065-03

Anatomical study of subtemporal anterior transpetrosal approach
ZHANG Xi-an,ZHONG Shi-zhen,QI Song-tao,et al.. Anatomical study of subtemporal anterior transpetrosal approach[J]. Chinese Journal of Otorhinolaryngology-skull Base Surgery, 2003, 9(2): 65-67,T001
Authors:ZHANG Xi-an  ZHONG Shi-zhen  QI Song-tao  et al.
Abstract:Objective To determine the anatomical features of subtemporal anterior transpetrosal (Kawase) approach. Methods Ten adult cadaveric heads were used for microsurgical dissection and measurement. Results After petrosectomy, the horizontal portion and internal auditory of the carotid artery canal was exposed, and the basal turn of cochlea between the carotid artery and canal was skeletonized. The size of the windows in the superior and medial surfaces of petrous bone averaged 2.6 cm2 and 1.9 cm2, respectively. In contrast with the subtemporal transtentorial approach, the additional exposure obtained in Kawase approach extended interiorly to the upper petroclival region, in which the vertebrabasilar and pontomedullary junction could be visualized. The arterial supply to dura in the exposed upper petroclival region mainly arose from meningohypophyseal trunk and ascending pharyngeal artery. Conclusion The Kawase approach can provide access to both the middle and posterior cranial fossa, and the exposed area of the posterior cranial fossa is limited to the upper half of the petroclival region.
Keywords:Petrosoclival region/anat  Subtemporal approach  Anterior petrosectmoy  Kawase approach
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