颅底外面枕骨基底部及周边骨性结构的测量和临床意义

目的为斜坡区肿瘤手术提供解剖资料。方法20例整颅,10例行水平切面,10例行正中矢状切面。测量切牙孔、前鼻棘、后鼻棘、枕骨大孔前端、枕髁前端、卵圆孔、破裂孔、颈动脉管外口及舌下神经管外口的内侧缘至咽结节的距离;测量卵圆孔、破裂孔、颈动脉管外口及舌下神经管外口的内侧缘至正中线的距离;测量枕骨基底部颅底外面的长径、枕骨大孔纵径(FML)、枕骨大孔前正中点与枕髁后缘连线垂直距离(AOCP)、枕髁轴径(OCA)、枕髁间距。结果切牙孔后缘、前鼻棘、后鼻棘、枕骨大孔前端、枕髁前端、卵圆孔、破裂孔、颈动脉管外口及舌下神经管外口的内侧缘至咽结节的距离分别为(mm):72.12±4.25、77.77±3.89、33.73±2.07、13.14±1.91、15.71±1.74、27.51±2.12、15.98±1.98、25.93±2.23、19.15±1.49。卵圆孔、破裂孔、颈动脉管及舌下神经管外口的内侧缘至中线的距离分别为:25.55±1.63、11.72±1.70、25.75±1.98、17.41±1.41。枕骨基底部颅底外面长径、FML、AOCP、OCA、枕髁间距分别为(mm):28.80±2.67、35.84±2.59、17.10±1.13、24.55±2.35、21.07±1.92。结论经口咽至斜坡区的手术入路中,开骨窗时安全范围是以咽结节为中心,以15mm为半径做斜坡磨除;也可以做矩形骨窗,即以咽结节为中心开一长(高)25mm×宽20mm的骨窗。

Measurement and clinic significance of bony structure of basilar part of occipital bone

Objective To provide anatomical data for operation of clivus.Methods Twenty whole Skull specimens,10 horizontal planes,10 median sagittal planes.To measure the distance from incisive foramen,anterior and posterior nasal spina,anterior part of greatoccipital foramen,anterior part of condyle occipital,inner border of outer entrance of oval foramen,lacerated foramen,carotid canal and hypoglossal canal to pharynxgeal tubercle;latest four items to central line;the length of basilar part of occipital bone,FML,AOCP,OCA;the distance of two occipital condyles.Results The distance from pharynxgeal tubercle to incisive foramen,anterior and posterior nasal spina,anterior part of greatoccipital foramen and condyle occipital,inner border of outer entrance of oval foramen and lacerated foramen and carotid canal and hypoglossal canal were:(72.12±4.25)mm,(77.77±3.89)mm,(33.73±2.07)mm,(13.14±1.91)mm,(15.71±1.74)mm,(27.51±2.12)mm,(15.98±1.98)mm,(25.93±2.23)mm,(19.15±1.49)mm;The distance from central line to latest four items were:(25.55±1.63)mm、(11.72±1.70)mm,(25.75±1.98)mm,(17.41±1.41)mm;the length of basilar part of occipital bone,FML,AOCP,OCA,the distance of two occipital condyles were:(13.14±1.91)mm,(15.71±1.74)mm,(28.80±2.67)mm and(21.07±1.92)mm.Conclusions In the operation from oropharynx to clivus,making a window in the clivus region which centered with pharyngeal tubercle and definited the radius of 15 mm is secure.In addition,in the operations,making a rectangle window which definited length(height)25 mm × width 25 mm is secure.