乙状窦沟的应用解剖研究

目的：探讨乙状窦的发育差异,为临床上乙状窦前,后入路手术提供形态学依据和资料。方法：采用140侧颅骨,用分规和游标卡尺测量乙状窦沟的宽度,深度及乙状窦沟的前缘至外耳道后壁的距离。部分颅骨以外耳门为中心作水平锯切,直接测量乙状窦沟的前缘至外耳道后壁的距离,同时进行Law氏位X线摄片对照,结果：乙状窦前缘至外耳道后壁的距离在10mm以上者108例（77％）,距离在8－9mm者21侧（15％）,距离在6－7mm者7侧（5％）,距离在5mm以下者4侧（3％）,以10mm为正常值,右侧的乙状窦前移多于左侧（18：14）,但无统计学差异,结论：乙状窦前移在国人中的发生率为23％,进行乙状窦前,后手术入略时应引起注意。     

下颈椎椎动脉孔及其毗邻的解剖学和影像学观测

目的：为下颈椎前路手术预防椎动脉损伤提供解剖学数据。方法：(1)取20具尸体的C3～7段作为解剖标本,作两侧椎动脉孔内缘间距、椎体横、矢径、椎动脉孔内缘和椎弓根内缘间距、椎动脉孔内缘和椎体外缘间距、 椎动脉孔内缘和钩突关节内外缘间距、椎动脉孔前后缘与椎体前后缘的垂直距离、 椎动脉孔矢径的测量。(2)选30例已确诊为颈椎病患者和50例正常人作为检测对象,用CT测量上述数据。 结果： (1) C_3～7两侧横突孔内缘间距、椎体横径、椎体矢径、C_3～6椎动脉孔矢径逐渐增大。(2) 钩突内缘与椎动脉孔内缘间距在6 mm之内, C_3～6椎体外缘与椎动脉孔内缘间距不超过3 mm。(3) C_3～6 横突孔矢径和椎体矢径比值恒定(30.32%～31.86%), C_3～5 椎动脉孔前缘与椎体前缘距离逐渐减小,C_3～5椎动脉孔后缘与椎体后缘距离逐渐增加。结论：本文的测量数值与不同个体的椎动脉资料相结合,为预防椎动脉损伤提供了解剖学依据。     

乙状窦前入路迷路后区应用解剖学研究

目的：为临床乙状窦前入路迷路后区域手术操作提供解剖学资料。方法：经10％甲醛溶液固定成人尸头标本15具共30侧。在外耳道后上棘、乳突上嵴、乳突尖之间磨除骨质，暴露乙状窦、岩上窦、岩上窦-乙状窦交点、颅中窝硬膜、乙状窦前方的颅后窝硬膜。磨出后骨半规管、外骨半规管、上骨半规管及面神经垂直段、颈静脉球。测量相关数据。结果：乙状窦前入路迷路后区域的骨质可分为三层：表面骨皮质，乳突蜂房骨质，覆盖深部结构的坚硬骨质。外耳道后上棘至后骨半规管的最近距离为（17．88±1．27）mm；面神经垂直段在外半规管下方、后半规管的前方走向二腹肌嵴前缘的内侧，其长度为（7．58～14．02）mm；外耳道后上棘．乙状窦最短距离为（13．84±2．74）mm。结论：此区域骨质分层明显的解剖学特点及测量的数据可以指导手术操作，避免损伤重要结构，为乙状窦前入路迷路后锁孔入路提供了重要的解剖学资料。     

The cerebral basal arterial network: morphometry of inflow and outflow components

The aim of this project was to study how the morphology of the incoming and outgoing arterial components of the cerebral basal arterial network influence the blood flow to the brain. The cerebral basal arterial network consists of the circulus arteriosus cerebri anteriorly and the basilar artery posteriorly. Diameters of inflow vessels (bilateral vertebral and internal carotid arteries), connecting vessels (anterior communicating, basilar and bilateral posterior communicating arteries) and outflow vessels (anterior, middle and posterior cerebral arteries) were measured and cross‐sectional areas calculated in 51 cadaveric brain specimens. The individual and the average cross‐sectional areas of inflow arteries (51.43 mm²) were significantly bigger than the major outflow arteries (37.76 mm²) but smaller than the combined cross‐sectional areas of outflow (37.76 mm²) and connecting (25.33 mm²) arteries. The difference in the size of arterial cross‐sectional area and the presence of the connecting arteries in the cerebral basal arterial network provides a mechanism for lowering peaks in pressure, and demonstrates a function of the cerebral basal arterial network.     

前庭小管外口的形态特点及其临床意义

目的：研究前庭小管的形态及毗邻关系,为经岩骨临床手术提供解剖学依据。方法：在32例（64侧）新鲜颅底标本上观察前庭小管的形状,并测量其长度及其到内听孔下后缘,下状窦前缘,岩骨嵴,颈静脉孔上缘的距离,对比双侧的差异,结果：前庭小管多为弧形（48％）,其次为S型（28％）,折线形最少,前庭小管长度及其到内听孔下后缘,乙状窦前缘,岩骨嵴,颈静脉孔上缘的距离平均值分别为：9．7,10．7,7,9．6,8．8和9．5毫米,其中到乙状窦和颈静脉孔的距离两侧有显著性差异,均以右侧较短,结论：前庭小管是经岩骨手术的重要解剖标志,国人和国外人种在解剖上存在一定差异,乙状窦前置和高颈静脉以右侧多见。     

乳突根治术中乙状窦沟的解剖学观测

目的测量乙状窦沟到周边结构的距离,为乳突根治术提供解剖学依据。方法模拟乳突根治术耳后入路进行解剖,测量乙状窦前板到外耳道后上棘的距离,乙状窦前板到砧骨短脚中点的距离,乙状窦前板到外半规管隆凸的距离,乙状窦上膝距外耳道后上棘的距离,乙状窦下膝距外耳道后上棘的距离。结果 (1)乙状窦前板到外耳道后上棘的距离(13.19±2.37)mm;(2)乙状窦前板到砧骨短脚中点的距离(18.25±1.97)mm;(3)乙状窦前板到外半规管隆凸的距离(14.58±1.66)mm。(4)乙状窦上膝距外耳道后上棘的距离(16.95±2.06)mm;(5)乙状窦下膝距外耳道后上棘的距离(19.59±2.24)bmm。结论测量乙状突窦沟距其与周边结构间的距离,为手术安全提供了解剖学基础。     

The distance of the sigmoid sinus and the middle fossa dura from the external auditory canal in chronic otitis media

Purpose

Mastoid pneumatization is reduced in most patients suffering from chronic otitis media (COM). In most studies, the relationship between the degree of pneumatization and the distance of the sigmoid sinus from the external auditory canal has been examined, yielding different results. This study addresses the relationship between COM and the distance of the sigmoid sinus and also middle fossa dura from the external auditory canal.

Methods

This was a case–control study on 15 adult COM patients, 12 traumatic facial palsy patients, and 15 cadaver temporal bones. After mastoidectomy, the distance between the spine of Henle and both the middle fossa dura and sigmoid sinus were measured, and the findings in each group was analyzed using Tukey’s and ANOVA tests.

Results

The average distance of the external auditory canal and the sigmoid sinus was 15.27 ± 3.3 mm in the COM group, 16.92 ± 3.23 mm in the traumatic facial palsy group, and 14.53 ± 2.92 mm in the cadaver temporal bones. There was no significant difference between the groups (p = 0.115). The average distance of the spine of Henle from the middle fossa dura was 6.73 ± 1.62 mm in the COM group, 11.4 ± 2.05 mm in the traumatic facial palsy group, and 8.93 ± 1.94 in the cadaver temporal bones. There was a significant difference between the groups (p < 0.001).

Conclusion

The distance of both the sigmoid sinus and the middle fossa dura from the external auditory canal (which indicates mastoid pneumatization) is reduced in COM patients.     

LefortⅠ颌骨整复术外部参考点确定的解剖学观测

目的 测量鼻根部到颅前窝、额窦的最短距离。为安全放置克氏针,确定外部参考点建立解部学指导。方法 选择20例正中矢状切开的成人尸头标本,使用游标卡尺,测量(1)鼻根点到前颅窝的最短距离;(2)额窦最低点到通过鼻根点水平线的最短距离。结果 从鼻根点到前颅窝的平均距离为15.6mm,从鼻根点到额窦的平均距离为4.5mm。结论 克氏针从前上向后下进入相对前颅窝和额窦为安全路径。     

Variations of the area and shape of the left atrioventricular valve and its cusps and leaflets

Summary Measurement of the areas of the cusps and leaflets of the left atrioventricular valve (LAV) and a study of their shape were performed in 91 normal human hearts, to assess the range of variation and determine the most frequent morphologic pattern. The average areas were as follows: LAV, 904.9 mm²; anterior cusp, 447 mm²; posterior cusp, 457 mm²; anterolateral leaflet, 118.6 mm²; intermediate leaflet, 212.7 mm²; and posteromedial leaflet, 126 mm². The commonest shape of the leaflets of the posterior cusp, proved to be rectangular.

---

Variations de la surface et de la forme de la valve atrioventriculaire gauche, de ses cuspides et languettes

Résumé La mesure de la surface des cuspides et des languettes de la valve atrioventriculaire gauche (LAV) et l'étude de leur forme ont été réalisées sur 91 coeurs humains normaux pour évaluer l'éventail des variations et déterminer la disposition morphologique la plus fréquente. Les surfaces moyennes furent les suivantes : LAV 904,9 mm² ; cuspide antérieure 447 mm²; cuspide postérieure 457 mm²; languette antéro-latérale 118,6 mm²; languette intermédiaire 212,7 mm²; languette postéro-médiale 126 mm². La forme la plus répandue pour les languettes de la cuspide postérieure s'est avérée être rectangulaire.

     

Anteroposterior distance between the tibial tuberosity and trochlear groove in patients with patellar instability

BackgroundOur objective was to describe a measurement to assess sagittal tibial tuberosity (TT)–trochlear groove (TG) distance and to compare this between asymptomatic (control) patients and patients with symptomatic patellar instability.MethodsWe compared static CT images of 22 fully extended knees of patients with symptomatic patellar instability with images of 22 asymptomatic knees. TT–TG distance was measured to quantify lateralization of the TT, and anteroposterior TT–TG distance was used to quantify the sagittal distance between these two points. Lateral trochlear inclination, sulcus angle, and trochlear depth were measured. Groups were compared using paired t tests (alpha = 0.05). Correlations of anteroposterior TT–TG distance with lateral trochlear inclination, sulcus angle, and trochlear depth were assessed using linear and multivariate regression.ResultsMean TT–TG distances were 19.9 ± 4.4 mm (symptomatic) and 16.8 ± 5.5 mm (control) (mean ± std deviation) (P = 0.002). Mean anteroposterior TT–TG distances were 8.3 ± 7.8 mm (symptomatic) and ? 0.5 ± 4.6 mm (control) (P < 0.0001). The symptomatic group had greater measurements of trochlear dysplasia, with lower lateral trochlear inclination, greater sulcus angle, and lower trochlear depth (all P < 0.0001). Anteroposterior TT–TG distance and trochlear depth were strongly negatively correlated (r = 0.62, R² = 0.39, P < 0.0001).ConclusionsIn asymptomatic patients, the anteroposterior TT–TG distance was ? 0.5 mm, indicating that the TG and TT were nearly in the same coronal plane. In patients with symptomatic patellar instability, the TG was almost nine millimeters anterior, and this distance correlated with measurements of trochlear dysplasia.Level of evidenceIII, case control study.     

Representation of the fovea in the superior temporal sulcus of the macaque monkey

Summary The response properties of 633 neurons from striate and prestriate cortex were recorded in 3 hemispheres of two awake cynomolgus monkeys while they fixated or tracked a small spot of light. Of 254 penetrations located at 1 mm intervals, 39% were identifiable from visible electrolytic lesions or electrode tracks and were used to reconstruct the positions of all recording sites. A total of 226 cells were located in the superior temporal sulcus and 81 cells in area V1. The location and visuotopic organization of the foveal portion of the middle temporal (MT) visual area were determined in three hemispheres. MT was defined physiologically on the basis of direction-selectivity, receptive field size, and retinotopic organization. Of 170 MT neurons, most were motion sensitive, and 65% had a directionality index, (best — opposite)/best, of 0.6 or higher. MT was defined anatomically on the basis of myelin staining within the superior temporal sulcus (STS). On the posterior bank of the STS the physiologically defined border corresponded closely to a myelin border visible on our sections. Distinct myelin borders were not consistently identifiable on the anterior bank. The representation of the central fovea (eccentricities of 0–1 deg) was located partly on the floor, but mostly on the posterior bank of the STS at the extreme postero-lateral edge of MT. In all three hemispheres foveal MT extended onto the roof of a cleft formed between the posterior bank and a wide flattened area on the floor of the STS. This region lies 10–12 mm below the brain surface, measuring along a line normal to the surface at a point 2–3 mm antero-lateral to foveal V1. The area of MT was 6–9 mm² for the central fovea (0–1 deg), 15–24 mm² for the entire fovea (0–3 deg), and 28–40 mm² including the fovea and parafovea (0–10 deg). A visuotopic map of central foveal V1 (0–1 deg) was obtained in one animal. The measured area of this representation was 116 mm². Using published estimates of the total areas of cynomolgus MT and V1 (73 and 1200 mm² respectively) the ratio of central foveal to total area was calculated to be 0.10 for both MT (7.5/73) and V1 (116/1200), indicating that the relative magnification of the foveal versus the peripheral visual field is preserved in the mapping of V1 onto MT. A separate representation of the central visual field was found immediately adjacent to foveal MT. This region, the FST area (Ungerleider et al. 1982; Ungerleider and Desimone 1986a, b), was distinguishable from MT in three ways: 1) by the presence of occasional visually unresponsive cells, 2) by the presence of cells with very large receptive fields intermingled with cells whose receptive fields are comparable in size to those found in foveal MT, and 3) by an increased incidence of cells responding during tracking. Of 34 FST neurons, 53% had a directionality index of 0.6 or higher. An additional 22 cells recorded in the superior temporal sulcus were judged to be outside both MT and FST.     

Nasal,sellar, and sphenoid sinus measurements in relation to pituitary surgery

A study of 24 adult Caucasian cadavers was undertaken to assess and document the anatomical measurements within the nasal cavity and sphenoid sinus as routes of instrumentation utilized in sublabial transsphenoidal and endonasal endoscopic approaches. Five measurements were performed. The mean thickness of the anterior sellar wall was 0.8 ± 0.3 mm for both the sellar and presellar types of sinuses, respectively. Also, the mean thickness of the bony floor of the sellar type of sinus was 0.9 ± 0.4 mm. In addition, the mean depth of the sphenoid sinus was 13.6 ± 5.1 mm for the sellar type and 13.2 ± 3.9 mm for the presellar type of sinus. Furthermore, the mean distance between the suspinale (inferior–posterior edge of the anterior nasal spine) and the anterior sphenoid wall was 62.3 ± 4.6 mm for the sellar type of sinus (P < 0.05) and 60.6 ± 2.9 mm for the presellar type of sinus, while the distance between the subspinale and the anterior sellar wall had a mean value of 75.9 ± 6.3 mm for the sellar type of sinus (P < 0.05) and 73.8 ± 4.2 mm for the presellar type of sinus, with the distance of the sellar type sinus being greater for male specimens. Sphenoid sinus pneumatization was of a conchal type in 4%, presellar type in 28%, and sellar type in 68% of subjects examined. The results of the current study expand upon current anatomical knowledge and may be beneficial in the future refinement of surgical instrument design. Clin. Anat. 23:629–636, 2010. © 2010 Wiley‐Liss, Inc.     

Tibial tubercle–trochlear groove (TT–TG) distance is a reliable measurement of increased rotational laxity in the knee with an anterior cruciate ligament injury

BackgroundThe aims of this study were: 1. To evaluate the use of the tibial tubercle–trochlear groove (TT–TG) distance as a measurement showing rotational instability after anterior cruciate ligament (ACL) injury. 2. To determine the effect of concomitant anterolateral ligament (ALL) injury on TT–TG distance.MethodsKnee magnetic resonance (MR) images of 251 patients were retrospectively evaluated to compare the study group (131 patients) who underwent ACL reconstruction due to acute complete ACL injury and the control group (120 patients) without any trauma and/or patellofemoral instability. The rate of secondary signs of ACL injury (Anterolateral ligament injury, Kissing lesion, Anterior tibial translocation, Buckling of the posterior cruciate ligament (PCL)) in the study group was noted. The relationship between the TT–TG distance and other secondary signs was examined.ResultsTT–TG distance was measured as 10.83 ± 1.2 mm, 12.88 ± 1.1 mm, 14.17 ± 1.5 mm in control, isolated ACL and ACL + ALL groups, respectively (p < 0.05). TT–TG distance was significantly higher in the patients with ALL injury and kissing lesions than the patients without these lesions (p ˂ 0.05). TT–TG distance did not differ significantly between the patients with and without anterior tibial translocation or buckling of the PCL (p ˃ 0.05). TT–TG distance measurements showed significant interobserver 0.994 (0.992–0.996) and intraobserver 0.997 (0.996–0.998) correlation.ConclusionsTT–TG distance measurement can be used as a reliable quantitative measure of the increased rotational instability after ACL injury. TT–TG distance increases significantly if there is an ALL injury accompanying the ACL injury.     

The membranous portion of the interventricular septum and its relationship with the aortic valve in humans

Summary Investigation of the membranous portion of the interventricular septum (MPIS) and its relationship with the aortic valve was performed in 32 human hearts of adult individuals (19 Caucasians and 11 non-Caucasians). With transillumination of the MPIS the specimens were photographed and 35 mm slides obtained. These were digitized into Apple Macintosh II using a Dage Model 68 video camera and a Data Translations DT 2255 frame grabber. The areas and the distances were traced manually, using the NIH Image program (Wayne Rasband, NIH, Research Services Branch, NIHM). The following forms of MPIS were found: oval (31.3%), triangular (28.1%), quadrangular (18.8%), circular (15.6%) and semilunar (6.2%); its surface area varied from 5.65 mm² to 142.63 mm² (mean 48.82±29.17 mm²). The superior border of the MPIS was in close relationship with the aortic valve, and its upper part was usually (41%) in direct continuity with the attachments of both right (RAC) and posterior (PAC) aortic cusps, or with PAC (34%) or RAC (6%) only. Rarely (19%) the MPIS lay below the attachments of both cusps. The distance between the MPIS superior border and the attachment of the RAC was not greater than 5.89 mm (mean 1.69 mm±1.9 mm). The distance between the superior border of the MPIS and the attachment of the PAC was not greater than 5.63 mm (mean 0.77±1.49 mm). Differences between sex, race and age groups were not statistically significant.

---

La portion membraneuse du septum interventriculaire et ses rapports avec la valve aortique chez l'homme

Résumé L'étude de la portion membraneuse du septum interventriculaire (PMSIV) et de ses rapports avec la valve aortique a été réalisée sur 32 curs humains adultes (19 Caucasiens et 11 non-Caucasiens). Sous transillumination, la PMSIV est photographiée et les diapositives de 35 mm obtenues sont numérisées dans le Apple MacIntosh II, utilisant une caméra vidéo « Dage Model 68 » et un convertisseur d'images « DT 2255 frame grabber ». Les surfaces et les distances sont tracées manuellement, utilisant le « programme d'images NIH » (Wayne Rasband, NIH, Research Services Branch, NIHM). Les formes suivantes de la PMSIV ont été observées : ovale (31,3 %), triangulaire (28,1 %), quadrangulaire (18,8 %), circulaire (15,6 %) et semi-lunaire (6,2 %). Sa surface varie de 5,65 mm² à 142,63 mm² (moyenne 48,82±29). Le bord supérieur de la PMSIV contracte des rapports intimes avec la valve aortique; sa partie haute est habituellement en continuité directe avec les pieds d'insertion des valuvles aortiques : les deux valvules droite (VAD) et postérieure (VAP) dans 41 %; la VAP ou la VAD isolément, respectivement dans 34 et 6 % des cas. Rarement (19 %) la PMSIV se situe au-dessous des bords adhérents de ces valvules VAD et VAP. La distance entre le bord supérieur de la PMSIV et l'insertion de la VAD n'est pas supérieure à 5,89 mm (M : 1,69 mm±1,9 mm). La distance entre le bord supérieur de la PMSIV et l'insertion de la VAP n'est pas supérieure à 5,63 mm (M : 0,77±1,49 mm). Les différences entre sexes, races et âges ne sont pas statistiquement significatives.

     

蝶窦前壁的外科解剖学研究

目的　探讨蝶窦前壁区的解剖特征及其在经蝶窦入路手术中的意义。 方法　用15例（30侧）成人头部标本及20例（40侧）成人头骨标本,在手术显微镜下对蝶窦前壁骨质、蝶腭动脉及其分支等结构进行观察和测量。 结果 蝶窦前壁的基本形态酷似鸟头,正中线棱状高起,两侧为鸟眼样的蝶窦口,下方为鸟喙样的蝶嘴。蝶窦口距上鼻道末端（14.5±1.1）mm,距后鼻孔上缘（12.2±1.0）mm,距鼻后中隔动脉上支（8.2±0.5)mm。自鼻孔伸入探条探测蝶窦前壁时,所探及的“最浅点”大致位于蝶窦口与后鼻孔之间的中点附近。蝶腭孔位于蝶窦口的外下方和中鼻甲的后端区域,与蝶窦口间距(6.9±1.3)mm,两侧蝶腭孔内侧缘间距(18.2±2.5)mm。 结论 蝶窦前壁具有特征性的形态,蝶窦口大致位于蝶窦前壁的上中1/3交界处,其下方的骨质向前方突起。蝶腭孔位于蝶窦口下外侧方约7 mm处,经蝶窦入路手术中可以依此定位蝶腭孔。     

颈椎前路减压手术解剖标志定位测量及其临床意义

目的　为颈椎前路减压手术在有限显露术野中达到安全、有效减压提供更科学的减压标志。 方法　在15具成人尸体标本上,解剖观测C3~7节段相关解剖数据,以所测量的数据为基础,计算：(1)椎体钩前脚至颈长肌内侧缘的距离/颈长肌内侧缘至正中矢状面的距离(AULD/MLPD); (2)椎体钩前脚至横突孔内侧缘的距离/椎体钩前脚至颈长肌内侧缘的距离(AUTD/AULD); (3)椎体钩前脚至硬膜囊外侧缘的垂直距离/椎体钩后脚至硬膜囊外侧缘的距离(AUDD/PUDD)和(4)椎体钩与神经根最近点和椎体钩前脚的垂直距离/椎体钩前后脚的垂直距离(UNAD/APUD)。 结果　AULD/MLPD在C3的平均值为0.83,在C4的平均值为0.55,在C5的平均值为0.20,在C6的平均值为0.34,在C7的平均值为0.27;AUTD/AULD的平均值为2.71;AUDD/PUDD的平均值为0.28;UNAD/APUD的平均值为0.34。 结论　椎体钩前脚是颈椎体前部恒定的解剖标志,可作为颈椎前路手术的稳定、可靠的骨性减压标志,依据AUDD/PUDD、UNAD/APUD和AUTD/AULD的比值,有助于术中判断硬膜囊、颈神经根和椎动脉的位置。     

Tensile properties of a morphologically split supraspinatus tendon

The supraspinatus tendon consists morphologically of two sub‐regions, anterior and posterior. The anterior sub‐region is thick and tubular while the posterior is thin and strap‐like. The purpose of this study was to compare the structural and mechanical properties of the anterior and posterior sub‐regions of the supraspinatus tendon. The supraspinatus tendons from seven human cadaveric shoulders were morphologically divided into the anterior and posterior sub‐regions. Length, width, and thickness were measured. A servo‐hydraulic testing machine (MTS Systems Corporation, Minneapolis, MN) was used for tensile testing. The maximal load at failure, modulus of elasticity and ultimate tendon stress were calculated. Repeated measures were used for statistical comparisons. The mean anterior tendon cross‐sectional area was 47.3 mm² and the posterior was 32.1 mm². Failure occurred most often at the insertion site: anterior (5/7) and posterior (6/7). All parameters of the anterior sub‐region were significantly greater than those of the posterior sub‐region. The moduli of elasticity at the insertion site were 592.4 MPa in the anterior sub‐region and 217.7 MPa in the posterior (P = 0.01). The ultimate failure loads were 779.2 N in the anterior sub‐region and 335.6 N in the posterior (P = 0.003). The ultimate stresses were 22.1 MPa in the anterior sub‐region and 11.6 MPa in the posterior (P = 0.008). We recognized that the anterior and posterior sub‐regions of the SSP tendon have significantly different mechanical properties. In a future study, we need to evaluate how best to repair an SSP tendon considering these region‐specific properties. Clin. Anat. 27:702–706, 2014. © 2013 Wiley Periodicals, Inc.     

Visualization of the tentorial innervation of human dura mater

Posterior projections of the ophthalmic division of the trigeminal nerve (the ophthalmic nerve) are distributed in the tentorium cerebelli as recurrent meningeal branches. We investigated the morphological tentorial distribution of the ophthalmic nerve. Fifty‐two sides of the tentorium cerebelli and adjacent dura mater obtained from 29 human specimens were stained using Sihler's method to examine the nerve fibres in the dural sheets. The innervation patterns of the tentorium cerebelli were classified into the following four types according to their distributions: Type 1, where nerve fibres projected to both the straight and transverse sinuses; Type 2, where nerve fibres projected only to the transverse sinus and lateral convexity; Type 3, where nerve fibres projected medially only to the straight sinus and the posterior part of the falx cerebri; and Type 4, where the nerve fibres terminated within the tentorium cerebelli. Images of the tentorium cerebelli were superimposed to identify areas of dense innervation. The incidence rates of Types 1–4 were 71.2% (n = 37), 21.2% (n = 11), 3.8% (n = 2) and 3.8% (n = 2), respectively. More branches of nerve fibres traversed towards the transverse sinus posterolaterally than towards the straight sinus medially. The space between the anterior half of the straight sinus and the medial tentorial notch can be considered a safe surgical area where innervation is scarce. The posterior part of the falx cerebri was innervated by the ophthalmic nerve that traversed to the straight sinus. The parietal branches of the middle meningeal artery in the lateral convexity that were projected orthogonally by the ophthalmic nerve traversed the transverse sinus, implicating their vulnerability and possible sensitivity under physiological or neurosurgical conditions. This study has revealed the macroscopic tentorial innervation of the dura mater in humans, which could be useful information for both neurosurgeons and neurologists.     

海绵窦上壁的应用解剖学研究

目的为经海绵窦(CS)上壁的手术提供解剖学资料。方法解剖观测15例(30侧)成人头颅标本CS上壁的解剖三角、脑膜及相关结构。结果①CS上壁为不规则的四边形,可分出3个解剖三角:颈动脉三角、动眼神经三角及前内侧三角;②动眼神经门的长径为(5.67±0.87)mm,短径为(1.09±0.35)mm;动眼神经鞘膜袋前深(4.69±1.31)mm,后深(6.50±1.58)mm;③上壁的脑膜结构有镰状韧带、前岩床皱襞、后岩床皱襞、床突间韧带,颈动脉床突韧带、颈动脉穴及颈动脉领、动眼神经鞘膜袋、远环及近环等,膜结构在前床突(ACP)尖形成复杂的膜复合体。结论CS上壁的解剖三角可作为CS的手术入路,其脑膜结构对于手术也具有重要意义。