海绵窦Dolenc入路的显微外科解剖学研究

目的对海绵窦（CS)经Dolenc入路进行显做外科解剖学研究，为途经该区的显做手术提供解剖学依据。方法模拟经Dolenc入路，对15具(30侧)灌注好了的尸头在放大5～20倍的手术显做镜下进行解剖、测量。结果联合硬膜内、外打开CS上壁和外侧壁，然后进入CS内，显露神经、血管。CS上壁及外侧壁各有与手术相关的解剖三角，近环的一部分形成颈内动脉(ICA)-Ⅲ硬膜，与视神经嵴相连，ICA床突段可有静脉丛。结论Dolenc入路显露充分、安全，可配合使用CS内各个三角处理其内病变。ICA床突段可位于CS内、外，而视神经嵴可作为区别CS和硬膜内邻近ICA瘤可靠的解剖学标志。

Microsurgical anatomy of cavernous sinus region via Dolenc approach

Objective To explore the detailed features of microsurgical anatomic structures in cavernous sinus (CS) region and emphasize the clinical relevance of these observations. Methods The CS regions were dissected and observed using microscope in 5-20 multiples magnification with micro-operative techniques through Dolenc approach in 30 specimens from 15 formalin-fixed cadaver heads. Results Lateral and superior walls of CS were entered with combination of intradural and extradural approaches. The optic strut accurately localized the point at which the ICA pierced the oculomotor membrane. The proximal ring was incompetent and admitted a variable number of veins from the cavernous plexus that accompanied the ICA throughout its clinoid segment. Conclusion Dolenc approach can improve satisfying surgical exposure and is safety. The clinoid segment of ICA varies in location of intracavernous and extracavernous. The optic strut provides a reliable anatomic landmark for intradural and extradural aneurysms.