颅底外面部分骨性标志三维坐标值及其意义

目的 :探讨测量颅底外面解剖结构三维空间坐标的方法并为临床应用提供相关数据。方法 :建立与颅底内面相统一的三维空间坐标系 ,在特制颅器上以 3 2个成年国人水平锯开颅骨标本为测量对象。结果 :测出了颅底外面骨性标志 2 1项共 3 4个测点的三维空间坐标值 ;可准确地测算出各测点在颅表各个方位的投影点和深度 ;根据坐标值和解析几何公式 ,还可推算出所有测点间连线 (线段 )的距离 (测距 )及其与三个基准坐标面的角度 (测角 )。结论 :明确了颅底外面各测点的空间位置和颅底内外两面任何测点间的位置关系 ,为颅底手术定位或放疗照射野等定位设计 ,提供了更为简便可靠的新方法。     

Skeletal variations of the seventh cervical vertebrae in the mouse with special reference to the foramina transversaria and the accessory foramina.

The formation of foramina transversaria in the seventh cervical vertebra of CBA and C57BL mice and their offspring is found to behave as if it is determined by a single semi-dominant gene. The accessory foramina of Weber (1950) are investigated in the same material. These foramina are classified into two types and their heredity is evaluated.     

钛网片在前颅底手术颅底重建中的美容作用

目的 探讨钛网片和带蒂颅骨膜在伴有较大颅底缺损的前颅底手术颅底重建术中的美容作用。方法 将钛网片放在折叠的具有良好血供的带蒂颅骨膜两层之间，对23例具有较大颅底缺损的患者进行颅底重建。结果 23例手术后无感染出现，无脑膜脑膨出，及局部塌陷，颅眶畸形得以矫正，容貌恢复满意，6例术后出现短时间脑脊液鼻漏，经腰穿和静脉预防性应用抗生素痊愈。结论 应用钛网片和血供良好的带蒂颅骨膜重建前颅底有很好的美容作用。     

Amyloidoma of the skull base

Localized amyloid tumors of the central nervous system are rare. We present the case of a 59-year-old white man with a large expansile amyloidoma at the base of the skull. To our knowledge this is the second reported case of localized amyloid tumor involving the skull.     

Variations in size and in symmetry of foramina of the human skull.

The goal of this report is to define an average size and size range for many of the skull's foramina and to determine in which paired foramina asymmetry is commonly found so that researchers and clinicians examining foramina may have an anatomical reference. The incidence of foraminal variations is also discussed. Information on skull foraminal size and symmetry is increasingly important because of the advancements in radiologic techniques such as magnetic resonance imaging (MRI) and computed tomography (CT). These methods are making difficult diagnoses of pathologic conditions of skull foramina possible. The foramina of 100 randomly selected dry skulls were measured and the symmetry of paired foramina was noted. The average, largest, and smallest sizes for 29 different foramina and the length of one canal are listed. Information regarding the symmetry of 27 paired foramina and the length symmetry of the infraorbital canal was also gathered. Specific data collected for paired foramina include the percent of skulls in which (1) neither foramen of the pair was present, (2) both foramina of a pair were present, (3) both foramina of the pair are present and were both the same size within 0.5 mm, and (4) both foramina of a pair are present but there was greater than 0.5 mm difference in size between them.     

An assessment on spiral CT scan of the superior and inferior genial spinal foramina and canals

To characterise the superior as well as the inferior genial spinal foramen and their bony canal using a large CT data sample. The study included 555 mandibular spirals CT scans, taken from patients for pre-operative implant planning. Basic observation by three observers included the number of canals, their respective anatomical location and morphological variations. Furthermore, linear measurements were performed to describe the foramina and canal characteristics. On spiral CT scans, the superior and inferior genial spinal foramina were detected in 448 CT scans (81%). In 29% of the mandibular CTs, two or more midline canals were noted. 47% of the foramina were located in a position inferior to the genial spines; the others were located in a superior position. The mean (SD) lingual and buccal diameters of the canal structures were 0.73 (0.27) and 0.54 (0.29) mm, respectively with an average length of 3.94 (1.29) mm. The canal was located on average 7.40 (5.31) mm from the mandibular base at the lingual entrance and 7.96 (3.47) mm at the buccal canal end point. The average canal extended towards the buccal bone for an average 37% of the bone width. The results demonstrated the presence of both superior and inferior genial spinal foramina, with 29% of the individuals having double foramina. About 53% of the foramina was located superior to the genial spines. Considering its neurovascular content, these foramina should be carefully evaluated during pre-operative planning.     

颈内静脉与颅底骨三维空间关系

】目的显示对比正常侧和病变侧颈内动静脉与周围骨结构的解剖关系，以完善术前准备。方法10例颌颈部肿瘤患者，术前行颈动脉三维CT血管成像(CTA)，同步注射造影剂，螺旋CT对病变区血管段进行重点薄层螺旋扫描，由Easy Vision工作站三维重建。结果5例颈外动脉和颈内静脉受压狭窄，其中3例出现颈总动脉、颈内动脉向内侧移位。CTA能够显示病变区血管段(包括颈总动脉、颈内动脉、颈外动脉、颈内静脉)与下颌骨、舌骨、颈椎、颅底骨结构的三维解剖关系，进行旋转、放大，三维测量，多视角观察，无重叠干扰。结论对颌颈、口咽部肿瘤患者术前CTA检查，能够判断颈部大血管的情况及颈部巨大肿瘤造成项内动脉移位，CTA可显示血管性肿瘤的三维形状和与颅底骨空间关系，为手术入路及术式提供参考，有助于降低手术风险。     

胸、腰椎上关节突棘的观测及临床意义

目的:通过对胸、腰椎上关节突棘形态的观测,为临床提供解剖学资料.方法:选用35例成人、2例儿童的完整干燥脊柱标本及5例胎儿脊柱湿标本,观察上关节突棘,用游标卡尺进行相关测量,结果:成人的颈椎、T1和L5及儿童和胎儿的全部脊柱标本上未观测到上关节突棘的存在,成人其余的胸椎和腰椎上均观察到上关节突棘,而且卜关节突棘多出现在下胸椎和L1,随着胸椎序数的增加上关节突棘的出现率有增加的趋势;随着腰椎序数的增加,上关节突棘的出现率有减少的趋势.结论:上关节突棘是成人胸、腰椎的骨性结构,有必要对其予以命名;其参与椎管和椎间孔的构成,可造成相应结构受压.     

颈内动静脉与颅底骨三维空间关系

目的 :显示对比正常侧和病变侧颈内动静脉与周围骨结构的解剖关系 ,以完善术前准备。方法 :10例颌颈部肿瘤患者 ,术前行颈动脉三维CT血管成像 (CTA) ,同步注射造影剂 ,螺旋CT对病变区血管段进行重点薄层螺旋扫描 ,由EasyVision工作站三维重建。结果 :5例颈外动脉和颈内静脉受压狭窄 ,其中 3例出现颈总动脉、颈内动脉向内侧移位 ,另 1例左侧颈内动脉动脉瘤清晰定位。CTA能够显示病变区血管段 (包括颈总动脉、颈内动脉、颈外动脉、颈内静脉 )与下颌骨、舌骨、颈椎、颅底骨结构的三维解剖关系 ,进行旋转、放大 ,三维测量 ,多视角观察 ,无重叠干扰。结论 :对颌颈、口咽部肿瘤患者术前CTA检查 ,能够判断颈部大血管的情况及颈部巨大肿瘤造成颈内动脉移位 ,CTA可显示血管性肿瘤的三维形状和与颅底骨空间关系 ,为手术入路及术式提供参考 ,有助于降低手术风险     

颅底应用解剖的研究进展

熟悉颅底区域的解剖特点 ,是开展颅底外科手术的基础。为了避免颞骨内的面神经、颈内动脉、内耳结构的损伤 ,可利用颞骨表面的标志判断颞骨内有关结构的位置。根据斜坡区的解剖特点 ,进入斜坡区的颅底手术入路归纳为三类 :前方入路、侧方入路、后方入路。这些手术入路有各自的优缺点 ,适合不同肿瘤的手术治疗     

Reflections on the mechanical structure of the base of the skull and on the face

Using thick sections of the base of the skull and face their mechanical structure is viewed from the engineering aspect and the anatomic solutions evolved are compared with those selected by Aerospatiale engineers for the concept and development of the Airbus. It is concluded that the anterior and middle cranial fossae, together with the face, constitute an inseparable mechanical assembly each of whose component units participate in the rigidity of the others. Since this mechanical assembly must provide maximal rigidity for minimal weight, this suggests that aeronautical solutions should throw much light on the detail of construction of the skull and face. Indeed, the rigidity and lightness of the latter are obtained by means of solutions familiar in aeronautics: the reliance on thin-shelled beams with a honeycomb filling, the diploe analogous to a preconstrained composite or sandwich structure, a system of frames, struts and stiffeners, and the use of fillets at the sites of junction of struts.     

The macro-microscopic anatomy of the cerebral dura mater on the internal surface of the skull base

The investigations of the inner base of the human skull have been carried out on 18 preparations using macro-microscopic preparation and morphometry of the basal parts of dura mater and a plaster model of their inner surface. Thickness of dura mater, fibrous framework constructions, its relief and interrelation with bony base have been studied.     

The ALX4 homeobox gene is mutated in patients with ossification defects of the skull (foramina parietalia permagna, OMIM 168500)

Foramina parietalia permagna (FPP) (OMIM 168500) is caused by ossification defects in the parietal bones. Recently, it was shown that loss of function mutations in the MSX2 homeobox gene on chromosome 5 are responsible for the presence of these lesions in some FPP patients. However, the absence of MSX2 mutations in some of the FPP patients analysed and the presence of FPP associated with chromosome 11p deletions in DEFECT 11 (OMIM 601224) patients or associated with Saethre-Chotzen syndrome suggests genetic heterogeneity for this disorder. Starting from a BAC/P1/cosmid contig of the DEFECT 11 region on chromosome 11, we have now isolated the ALX4 gene, a previously unidentified member of the ALX homeobox gene family in humans. Mutation analysis of the ALX4 gene in three unrelated FPP families without the MSX2 mutation identified mutations in two families, indicating that mutations in ALX4 could be responsible for these skull defects and suggesting further genetic heterogeneity of FPP.


Keywords: ALX4; FPP; DEFECT 11