神经内镜下桥小脑角区迷路动脉的应用解剖学研究

目的为累及迷路动脉的病变在内镜下手术提供解剖学基础。方法结合神经内镜和显微镜技术,在8具(16侧)尸头标本上模拟乙状窦后入路解剖,观察、测量并记录迷路动脉的起始、管径、变异、行程和相对解剖位置的关系。结果迷路动脉可分为单支型和多支型;迷路动脉数量每侧为1～3支,其中7侧为单支,8侧为双支,1侧为3支;14侧起于小脑前下动脉,2侧起于基底动脉,未见有起于小脑后下动脉者。迷路动脉的管径为0.1～0.28mm,平均(0.18±0.05)mm。结论本研究为内镜辅助下桥小脑角区占位性病变切除术和微血管减压术中保护蜗神经、迷路动脉和保留残余听力、微血管充分减压提供了依据。

Neuroendoscopic and microsurgical anatomy of labyrinthine arteries in cerebellopontile angle regions

Objective To provide the basis of the anatomy for neuroendoscopic surgery and microsurgery for the lesions related to the labyrinthine arteries（LAs） in the cerebelopontile angle regions. Methods The neuroendoscopic surgery and microsurgery through the retrosigmoid approach were imitated in 8 cadaveric heads（16 sides） including 2 fresh and 6 formalin-fixed cadaveric heads. The number,diameter,origin and run of LAs and their relationship with the structures around them were observed and measured. Results LAs were divided into single trunk type and multiple trunk type. The number of LAs varied from one to three per side. LAs came from the inferior anterior cerebellar arteries in 14 sides and came from the basilar arteries in 2 sides of 16 sides of 6 cadsaveric heads. LAs had diameters ranging from 0.1 mm to 0.28 mm,and average diameter of（0.18±0.05） mm. There was only one LA per side in 7 sides,there were two LAs per side in 8 sides,and there were three LAs in one side. Conclusion The present study provides the anatomic basis for protecting cochlear nerve,LAs,and keeping residual hearing on the resection of the lesions and microvascular decompression in the cerebellopontile angle regions.