颞下窝A型入路的显微解剖研究

目的通过观察颅骨标本颈静脉孔及周围重要结构和在尸头标本上模拟颞下窝A型入路,获得相关的国人解剖学数据,为临床应用提供参考。方法选取10例颅骨标本测量颈静脉孔大小及与周围重要结构间距离;应用10例尸头标本对颞下窝A型入路的相关结构进行显微解剖研究和测量。结果 1颈静脉孔外口距茎突根（4.17±1.99）mm、距茎乳孔（6.06±1.71）mm、距舌下神经管（2.41±1.23）mm;2面神经鼓室段长度（9.66±1.41）mm、乳突段长度（16.08±2.15）mm、面神经锥段距外半规管（1.08±0.41）mm;3颈静脉球距面神经乳突段（6.56±1.81）mm、距后半规管弓峰下缘（3.67±1.27）mm;4岩骨内颈内动脉垂直段长度（10.36±2.31）mm、水平段长度（19.41±2.02）mm;5后半规管弓峰下缘距寰椎横突（31.22±1.93）mm、乙状窦垂直臂距下颌关节（19.17±1.51）mm、乳突尖距岩尖（53.91±4.82）mm。结论颞下窝A型入路可充分暴露颞下窝后部及迷路下区特别是颈静脉孔区,适用于切除迷路下区及颈静脉孔周围病变。

Microanatomic study of type A infratemporal fossa approach

Objective To obtain anatomical data in Chinese related to type A infratemporal fossa approach and to provide reference for clinical application. Methods The size of jugular foramen and the distances between jugular foramen and surrounding important structures were measured on ten skulls. Mimic type A infratemporal fossa approach was performed under microscope on ten adult cadaveric heads. Results （1） The distances from external aperture of jugular foramen to styloid process root, stylomastoid foramen and hypoglossal canal were （4. 17± 1.99 ）mm, （6.06±1.71 ） mm and （ 2.41±1.23 ）mm respectively. （2）The lengths of tympanic and mastoid segments of facial nerve were （9.66 ±1.41 ）mm and （16.08 ±2. 15 ）mm. The distance from the pyramid segment of facial nerve to lateral semicircular canal was （ 1.08 ± 0.41 ） mm. （3）The distance from jugular bulb to mastoid segment of facial nerve was （ 6. 56 ± 1. 81 ）mm and the distance from the peak of jugular bulb to the lowest point of posterior semicircular canal was （ 3.67 ± 1. 27 ） mm. （4）The lengths of vertical and horizontal segments of petrous internal carotid artery were （ 10. 36± 2. 31 ） mm and （ 19. 41 ± 2. 02） mm. （5）The distance from the lowest point of posterior semicircular canal to transverse process of atlas was （31.22 ± 1.93 ）mm. And that from vertical segment of sigmoid sinus to mandibular joint was （ 19. 17 ± 1.51 ）mm, while that from the mastoid tip to petrous apex was （53.91±4.82 ）mm. Conclusions The type A infratemporal fnssa approach can sufficiently expose the posterior part of infratemporal fossa and the labyrinth zone, especially jugular foramen. It can be mainly used for resecting lesions under the labyrinth zone, especially lesions around jugular foramen.