脑神经海绵窦段的显微解剖及其临床应用

目的　为海绵窦 (cavernoussinus,CS)直接手术提供解剖学基础。方法　在手术显微镜下对 15例 (30侧 )成人头颅标本CS内脑神经位置、行径以及与颈内动脉CS段的毗邻关系进行观测。结果　①动眼神经入窦点在前床突尖后方 (4 5 7± 1 0 5 )mm ,与滑车神经、眼神经垂直距离分别为 (2 2 0± 0 6 7)mm和 (4 37± 1 35 )mm。②滑车神经入窦点与眼神经垂直距离为 (5 5 2± 1 0 6 )mm。滑车神经CS段行程形状可分为三型。③颈内动脉后曲顶高出眼神经和展神经上缘分别为 (5 5 2± 1 84)mm和 (6 6 0± 1 94)mm。④经前床窦尖外侧或外下方时 ,动眼神经、滑车神经及眼神经与前床突尖垂直距离分别为 (1 85±0 75 )mm、(5 30± 1 0 4)mm和 (6 6 1± 1 6 3)mm。结论　掌握脑神经CS段的显微解剖对CS的直接手术具有重要意义。

Microanatomy and clinical applies of the intracarvernous cranial nerves

Objective To provide microanatomic base for the operation on cavernous sinus(CS). Method The location,course and the relation to the internal carotid artery(ICA) of the intracavernous cranial nerves were observed and measured on 30 sides of adult cadaverical heads of Chinese under microscope. Results ①The point of oculomotor nerve entering CS was (4 57±1 05)mm posterior to the apex of anterior clinoid process(ACP),the vertical distance from the point to trochlear nerve and ophthalmic nerve was (2 20±0 67)mm and (4 37±1 35)mm respectively. ②The vertical distance from the point of trochlear nerve entering CS to ophthalmic nerve was (5 52±1 06)mm. The course of intracavernous trochlear nerve was various,and had three types of it. ③The roof of posterior curve of ICA was(5 52±1 84)mm and (6 60±1 94)mm higher than ophthalmic nerve and abducent nerve respectively. ④The vertical distance from the apex of ACP to oculomotor nerve,trochlear nerve and ophthalmic nerve were (1 85±0 75)mm,(5 30±1 04)mm and (6 61±1 63)mm respectively. Conclusion To master the microanatomy of intracavernous caranial nerves has certain significance for direct operation of CS.