岩静脉及其与三叉神经关系的应用解剖

目的通过解剖国人尸体头颅标本,观察岩静脉起始与终止部位、形态、行程特点及其与三叉神经的毗邻关系,为三叉神经微血管减压术提供解剖学依据。方法用经10%福尔马林充分固定的成人尸头颅标本12例（24侧）,在手术显微镜下解剖岩静脉与三叉神经等结构,观察上述神经、血管的位置、走行方向及其相互关系,测量岩静脉长度、外径及其与三叉神经根最近距离等相关数据。结果在24例标本共发现岩静脉35支;其属支交汇处直径为（2.44±0.87）mm（1.15~4.10 mm）,汇入岩上窦处直径（2.60±0.93）mm（1.20~4.50 mm）;岩静脉主干长度为（5.05±3.53）mm（1.75~8.95 mm）;共有7支主干及2条束支与神经根接触或压迫,除7条主干接触者外,其主干与三叉神经根最近距离（7.09±4.48）mm（1.20~12.60 mm）。结论岩静脉与三叉神经关系密切,可与三叉神经接触并压迫神经,成为三叉神经痛发生的解剖学基础之一。岩静脉呈游离悬空状,其主干多粗短,术中易因过度牵拉而破裂出血导致严重的后果,对岩静脉影响手术者应提前将其分离后电凝切断。

Applied anatomy of petrosal vein and its relationship with trigeminal nerve

Objective To provide anatomical basis for surgical operation of trigeminal neuralgia microvascular decompression by observing the location,morphology,course of petrosal vein and its syntopy with the trigeminal nerve in adult head specimens.Methods The petrosal veins and trigeminal nerves of 24 sides formalin-fixed specimens of adult head were exposed under surgical microscope.The location,morphology,course and the syntopy between them were observed.The length,diameter of petrosal vein and the shortest distance between the vein and trigeminal nerve were measured.Results Thirty-five petrosal veins were found in 24 specimens.The diameter of interchange was（2.44±0.87） mm（1.15~4.10 mm） and that of import petrosal sinus was（2.60±0.93） mm（1.20~4.50 mm）.The length of venae petrosa stem was（5.05±3.53）mm（1.75~8.95 mm）.In all,seven petrosal veins and two tributaries were compressed or touch the trigeminal nerve root.Except the seven main stems,the shortest distance from the other main stems to trigeminal nerve trunk was（7.09±4.48） mm（1.20~12.60 mm）.Conclusion There is a close relationship between the petrosal vein and trigeminal nerve.The petrosal vein may touch and compress trigeminal nerve and this may become the anatomical foundation for prosopalgia.The petrosal veins are floating or suspended and have stubby main stem.Electric coagulation should be applied to avoid excessive traction induced by bleeding during surgery.