侧颅底的横断层解剖及临床意义

目的为侧颅底病变的影像诊断及手术入路提供解剖学基础。方法选取成人尸体头颈部20例,沿眶耳线(OML)制成横断层解剖标本。在卵圆孔和咽隐窝层面上,观察侧颅底结构的解剖学关系,利用游标卡尺测量侧颅底内重要结构的径线及结构之间的距离。结果侧颅底横断层面可清晰显示卵圆孔、棘孔、耳蜗导水管、颈动脉管水平段、茎突等侧颅底结构及其毗邻关系和咽旁间隙、颞下间隙内的结构,是显示咽隐窝与咽旁间隙位置关系的最佳断层影像方式。茎突是侧颅底影像诊断及手术入路时观察各结构间位置关系、咽旁间隙分区和寻找神经、血管的骨性标志。两侧侧颅底结构呈对称性分布,重要结构的径线及结构之间的距离均无显著性差异。结论对侧颅底病变的影像诊断和设计手术入路等具有重要意义。

Transverse sectional anatomy and clinical significance of the lateral cranial base

Objective To provide anatomical basis for imaging diagnosis and surgical approach of the diseases of lateral cranial base.Methods 20 headneck of adult corpses were selected and cut into the transverse section from the OML.At the foramen ovale and pharyngeal recess level, anatomical relationship of the structures of lateral cranial base were observed, and measured in the diameter and distance between the important structures of lateral cranial base with the vernier caliper.Results The transverse section could clearly display the foramen ovale, foramen spinosum, cochlear aqueduct, horizontal part of carotid canal, styloid process of lateral cranial base and its adjacent structures, and the structures in parapharyngeal space, infratemporal space of the lateral cranial base.It was better sectional and imaging type to show the relationship of the pharyngeal recess with the parapharyngeal space with the transverse section.Styloid process was bony mark for observing relationship among the structures, zoning the parapharyngeal space and searching the nerve and vessels when imaging diagnosis and surgical approach of the lateral cranial base.The structures of lateral cranial base were symmetrical of both side , there were no significant differences in the diameter and distance between the important structures.Conclusion It has an important significance for imaging diagnosis and planning surgical approach of the diseases of lateral cranial base.