远外侧经髁手术入路的显微外科解剖研究

目的为远外侧经髁手术入路提供较详细的基本显微解剖标志和重要的解剖学参数,以利术中保护重要结构。方法应用１０例成人尸体头湿标本,１０例干标本进行显微解剖测量。结果乳突、乳孔、颈静脉窝、枕髁都是重要的术中解剖学标志。枕下三角是暴露椎动脉入颅前一个重要解剖学标志,枕下三角由头后大直肌、头上斜肌、头下斜肌三块肌肉组成。在寰椎水平有连接颈深静脉和硬膜外静脉丰富的静脉丛伴椎动脉周围,是术中显露椎动脉时重要的出血来源。并应用此入路及解剖学研究结果切除８例斜坡和颈静脉孔区肿瘤,证明手术顺利。结论这些测量提供了重要的解剖学参考,可保证手术顺利进行,不造成重要结构损伤。

Microsurgical anatomy of far-lateral transcondylar approach

Objective To supply the far lateral transcondylar approach with some basic microsurgical anatomy and to protect vital structure.Method We examined 10 cadveric adult heads and 10 dry skulls.Results Mastoid process, jugular fossa, and occipital condyle were important signs.Inferior occipital triangle was formed by muscle rectus capitis posterior major, muscle oblique capitis superior, and muscle oblique capitus inferior, the important mark for distinguishing vertebral artery. Abdundant venous plexus around vertebral artery was the important bleeding source during operation.Conclusion The aforementioned anatomic landmarks assist in localization, protection of vital structures.