与侧颅底手术有关的颈静脉球区解剖研究

目的为了提高对侧颅底手术中颈静脉球空间形态的认识。方法对20具成人尸头40侧颈静脉球高度、顶部骨质气化、毗邻结构进行了解剖观测。结果发现颈静脉球与面神经垂直段最短距离为2.67±1.23mm(0～4.62mm)，左右侧无显著差异；与鼓室最小间隔为右侧3.12±1.46mm(0～6.16mm)，左侧4.86±2.04mm(1.02～9.26mm)，P<0.05；高位颈静脉球出现率为17.5%(7/40)，右侧为30%(6/20)，左侧为5%(1/20)，P<0.05；右侧颈静脉球高度为9.29±1.78mm(6.58～14.26mm)，左侧为6.04±2.98mm(0～11.84mm)，P<0.001；颈静脉球顶部骨质硬化时其高度为5.33±3.21mm(0～9.54mm)，非硬化时高度为8.90±2.08mm(2.68～14.26)，P<0.001；颈静脉球到内耳道最短距离为右侧5.82±1.64mm(3.16～8.62mm)，左侧8.02±2.38mm(4.26～17.12mm)P<0.05。结论正常人左、右侧颈静脉球区解剖有一定规律及差异，熟悉颈静脉球解剖，有助于侧颅底手术顺利进行。

Anatomic study of the jugular bulb area related with lateral skull base surgery

Objective　 To study jugular bulb configuration in lateral skull base surgery. Methods 20 adult head cadavers were dissected. The following items were investigated: 1)Height of the jugular bulb (H); 2)Distance between the jugular bulb and vertical part of the facial nerve (F); 3)Distance between the jugular bulb and tympanic cavitas (T); 4)The incidence of the high jugular bulb (HJB); 5)Relation between (H) and the sclerotic or nonsslerotic bone on the jugular bulb; and 6)Distance between the jugular bulb and internal acoustic meatus (A).Results　The mean (F) was 2.67±1.23mm(0～4.62mm), and (F) was similar between the right and left sides. The mean (T) of the right and left sides were 3.12±1.46mm(0～6.16mm) and 4.86±2.04mm(1.02～9.26mm)respectively (P<0.05). The incidence of HJB was 17.5%(7/40), 30%(6/20) and 5%(1/20) for the right and left sides (P<0.001). The right and left sides (H) were 9.29±1.78mm(6.58～14.26mm) and 6.04±2.98mm(0～11.84mm) (P<0.001). (H) of the sclerotic bone on the jugular bulb was 5.33±3.21mm(0～9.54mm), while (H) of the nonsclerotic bone was 8.90±2.08mm(2.68～14.26mm) (P<0.001). (A) was 5.82±1.64mm(3.16～8.62mm) and 8.02±2.38(4.26～17.12) for the right and left sides (P<0.05). Conclusion　Knowing jugular bulb configuration is favorable in lateral skull base operation and correct diagnosis.