桥小脑角内镜下解剖分区及临床意义

目的:通过神经内镜对桥小脑角分区并行解剖学观察,旨在为内镜辅助该区域病变的手术治疗提供解剖学依据。方法:采用15具10%甲醛溶液固定的成人尸头和1具新鲜尸头标本,经乙状窦后锁孔入路在内镜下对桥小脑角分区并观察。结果:桥小脑角区从头侧至尾侧被Ⅶ-Ⅷ神经束、CNⅨ分为3个间隙:间隙Ⅰ、间隙Ⅱ、间隙Ⅲ,其中间隙Ⅰ又被CNⅤ分为Ⅰa、Ⅰb亚间隙(Subspace);内镜从3个间隙可以分别观察CNⅢ-CNⅫ及其附近的血管结构。结论:神经内镜选择性地在3个解剖间隙进行操作和甄别,减少了操作的盲目性,对显微外科起重要的辅助作用。

Anatomy division of the cerebellopontine angle under endoscope and its clinical significance

Objective： To observe the anatomy division of the cerebellopontine angle （CPA） under neuroendoscope in order to provide anatomic information for clinical treatments of localized lesions. Methods： Fifteen heads of adult cadavers soaked in formalin and one fresh adult cadaver head were used to observe CPA structures under microscope and endoscope which was inserted by retrosigmoid approach. Resuits： It was shown that CPA was divided into three compartments, Space Ⅰ , Ⅱ , Ⅲ , by the Ⅶ-Ⅷ bundle and the Ⅸ cranial nerve, of which the space Ⅰ was subdivided into two compartments, namely Ⅰ a and Ⅰb subspaces. The Ⅲ-Ⅻ cranial nerves and their adjacent vascular structures can be visualized under neuroendoscope through the three compartments. Conclusion. Under neuroendoscope, the three anatomical compartments can be visualized and differentiated, which can be great help for operators in microsurgery.