翼腭窝的显微和断层解剖研究及应用

目的 研究翼腭窝区解剖特点,为经上颌颅底手术入路提供解剖资料.方法 在10个甲醛固定成人头颅标本上,显微镜下观察翼腭窝内神经血管的解剖毗邻关系.利用冷冻铣切技术,获得横断、冠状及矢状位0.1 mm层面,在断面上连续追踪、观察翼腭窝的解剖结构.结果 翼腭窝内有上颌神经、翼管神经、蝶腭神经节及上颌动脉等重要结构,其内容物分为血管层和神经层.翼腭窝的解剖标志有圆孔、蝶腭孔及翼突,圆孔至翼管前口的距离为(0.872±0.242) cm,翼管至蝶腭孔的距离为(0.946±0.262) cm.圆孔位于眶上裂的外下方,圆孔至眶上裂距离为(0.846±0.264) cm.结论 冷冻铣切技术获得的断面清晰地显示了翼腭窝的解剖关系；显微和断层解剖方法相结合,阐明了翼腭窝区神经与血管分层的解剖特点,圆孔、蝶腭孔、翼突及翼管外孔可作为该区域的定位解剖标志.

Microsurgical and sectional anatomy of pterygopalatine fossa for operative approach

Objective To study the anatomical characteristics of pterygopalatine fossa for skull base approaches.Methods The anatomical relationship between vessels and nerves of pterygopalatine fossa on ten cadveic head specimens with microanatomy skills were studied.Thin clices of 0.1 mm were gotten on axial、coronal and sagittal planes.Continous sections were invested on the pterygopalatine fossa.Results There were maxillary artery and nerve,sphenopalatine ganglion,canalis pterygoideu in this region.There were two layers of tissues in pterygopalatine fossa:never layer and vessel layer.Foramen rotundum、pterygoid process and sphenopalatine foramen were identified as immportant landmarks.The distances from foramen rotundum to anterior aperture of canalis pterygoideu,anterior aperture of canalis pterygoideu to sphenopalatine foramen and foramen rotundum to superior orbial fissure were seperately (0.872± 0.242) cm,(0.946 ±0.262) and (0.846 ±0.264) cm.Conclusions Freezing milling tecnique slices could offer better understanding of the anatomical characteristics of pterygopalatine fossa.There are such anatomical landmarks as foramen rotundum、pterygoid process and sphenopalatine foramen.