经口咽手术入路处理颅颈交界区病变手术入路的解剖学研究

目的 通过解剖成人尸体,进行相关测量,为经口咽手术提供准确安全的解剖学数据.方法 对5例新鲜冷冻尸体和5例经福尔马林浸泡的尸体标本进行解剖,观察其解剖层次,测量颅颈交界区软组织暴露范围,寰枢椎部分解剖结构,骨窗宽度,C1、C2水平椎动脉内缘与中线的距离的具体数据.结果 经口咽前路手术入路能够充分暴露软组织,能直接显露从斜坡中下段至C3椎体上缘的范围,斜坡下缘到C3椎体上缘纵向距离为(51.41±4.32)mm,左右边界暴露的横向距离为(39.75±3.45)mm,寰椎前弓骨窗宽为(18.28±3.20)mm,枢椎骨窗宽为(15.95±1.67)mm,斜坡下部骨窗宽为(17.00±1.54)mm,双侧椎动脉到中线的距离C1水平左侧为(24.69±2.57)mm、右侧为(24.66±2.54)mm,C2水平左侧为(17.96±2.71)mm、右侧为(18.00±2.67)mm.结论 经口咽手术入路处理颅颈交界区病变是可行的,测量的相关数据可为临床手术提供安全可靠的数据参考.

Anatomic study of Transoral surgical approach for craniovertebral junc- tion lesions

Objective To provide the accurate security anatomy data for the surgical approach from the oropharynx. through the method of the adult autopsy and correlation measurement. Methods 5 cases of fresh frozen corpses and 5 cases of formalin-soaked specimens were dissected, the anatomy of the hierarchy was observed, scope of soft tissues exposed in eraniovertebral junction, atlanto-axial vertebral anatomical structure, axis bone window width and the dis- tance between vertebral artery at el, C2 level and the middle line were measured. Results The surgical approach from the oropharynx could be adequate exposured of soft tissues, directly exposed to the upper edge of C3 vertebral body from the lower slopes following paragraph. The distance between lower edge of the slope to the upper edge of C3 vertical was （51.41±4.32） mm, cross range of the left and right borders exposed was （39.75±3.45） ram. Anterior arch of the atlas bone window width was （18.28±3.20） ram, window width axis vertebrae was （15.95±1.67） ram, width of the lower slopes bone window was （17.00±1.54） ram, the distance between bilateral vertebral artery to the middle line at the level of C1 in the left was （24.69±2.57） mm, in the right was （24.66±2.54） mm, and at the level of C2 in the left was （17.96±2.71） mm, in the right was （18.00±2.67） mm. Conclusion The surgical approach from oropharynx is feasible to deal with the eranioeervieal junction lesions, our data may provide secure data reference for clinical surgery.