斜方肌筋膜带血管蒂肌瓣转移重建硬脑膜

目的 :经枕下 -乙状窦后入路行枕骨区肿瘤的显微解剖 ,并初步探讨位于斜方肌区的浅筋膜和带血管蒂肌瓣转移重建硬脑膜的可行性。方法 :在枕外隆凸下缘中点处作 T字型切口 ,去除左侧枕骨。沿横窦、乙状窦下缘剪下硬脑膜 ,显微解其神经血管。剪下硬脑膜平放于斜方肌筋膜表面 ,比准大小、周围大于硬脑膜 0 .5 cm,(注意切取时无破损处 )。将切下斜方肌区的浅筋膜和带血管蒂肌辩逆行转移至重建区与硬脑膜缝合 ,硬脑膜缝合时应留余脑的空隙。并对90例成人头颈正中矢状切上肢标本进行定位、测量。结果 :枕外隆凸最高点至枕骨大孔后缘间的距离 ;男性为 (5 0 .1± 2 .2 ) mm。女性为 (4 8.4± 1.6 ) m m。枕外隆凸最高点下方 2 0 m m处骨板厚度 ,男性为 (9.5± 0 .5 ) mm。女性为 (9.2± 0 .5 )mm。枕外隆凸最高点下方 2 .5 m m处骨板厚度 ,男性为 (8.6± 0 .4 ) m m。女性为 (8.3± 0 .4 ) mm。枕外隆凸最高点下方 30mm处骨板厚度 ,男性为 (7.3± 0 .4 ) m m。女性为 (7.1± 0 .3) m m。结论 :枕颈融合术、螺钉固定深度在 5 mm内一般较安全。枕鳞区硬脑膜修复采用斜方肌区筋膜和带有血管蒂肌瓣转移重建硬脑膜从解剖基础是可行的

The Inclined and Square Muscle Fascia Takes the Afferent Muscle Petal Transfers the Hard Meninges in Reconstruction

Objective Through Occipital bone- sigmoid sinus into the microscope anatomy of the road an Occipital bone area tumor, combine the superficial fascia first step study locate the area of trapezius with take the afferent muscle petal transfers the possibility that rebuild the cerebral dura mater. Methods Make in the next the middle point of the type of T slice, do away with the left side Occipital bone.Along the transverse sinus, sigmoid sinus next the shears the next cerebral dura mater, the its nerve in anatomy in microscope is afferent. Shearing the next cerebral dura mater is placed levelly in trapezius superficial fascia surface, the ratio allows the big and small ⒅Т form erebral dura mater0.5cm,.( the attention slices to take have no damaged place)Will slice the superficial fascia of the next the area of trapezius with take the afferent muscle argue the treacherous acts transfers to the reconstruction area to sew up with cerebral dura mater, the cerebral dura mater sews up should stay the crevice of the remaining brain.And to 90 example person a neck slices the arms specimen proceeding fixed position and measure exact center. Results External occipital protuberance apogee to foramen magnum empress distance; Male is (50.1±2.2)mms. Female is (48.4±1.6)mms.The external occipital protuberance apogee is under a bone plank thickness, male for (9.5±0.5)mms. Female is (9.2±0.5)mms. The external occipital protuberance apogee is under a bone plank thickness, male for (8.6±0.4)mms. Female is (8.3±0.4)mms. The external occipital protuberance apogee is under a bone plank thickness, male for (7.3±0.4)mms. Female is (7.1±0.3)mms. Conclusion The occipital neck blends surgical operation, bolt the fixed depth is generally more safe in 5 mmses. The Occipital bonecerebral dura mater repairs to adopt the trapezius area superficial fascia with take the afferent muscle petal transfer to rebuild the cerebral dura mater to is viable from the anatomy.