海绵窦内颅神经血液供应显微外科解剖研究

目的 为减少海绵窦显微外科手术时损伤海绵窦内颅神经血供而研究这些颅神经的血液供应解剖。方法 50具成人尸体海绵窦标本，在解剖显微镜下解剖和分析。结果（１）９０侧（占90％）的标本示动眼神经由颈内动脉的下外侧动脉分支供血；（2）滑车神经近段有74例（占74％）的标本示其接受下外侧动脉的分支供血，有26例（占26％）标本示其接受脑膜垂体动脉分支天幕动脉的供血，滑车神经远段主要由下外侧动脉的分支供血；（3）在Dorellos管区域，外展神经近段接受脑膜背侧动脉的血供，中段及远段由下外侧动脉的分支供血；（4）三叉神经的眼支和上颌支由下外侧动脉的分支供血，三叉神经节的内侧部由下外侧动脉和天幕动脉的分支供血，中部由下外侧动脉的分支供血，外侧部由下外侧动脉的分支或由脑膜中动脉供血。结论 下外侧动脉在海绵窦内颅神经供血中起重要作用。术中我们应保护这些血供，就可减少术后颅神经功能障碍。

The blood supply of the intracavernous cranial nerves: a microsurgical anatomy study.

Objective　To minimize injurying of the blood supply of intracavernous cranial nerves during microsurgical operation on cavernous sinus. Methods　50 adult cadaver brains include cavernous sinus were dissected in detail under anatomical microscope. Results　(1) The oculomotor nerve received branches from the inferolateral trunk in 90% of the specimens. (2) The proximal trochlear nerver received branches from the inferolateral trunk in 74% of the specimens and from the tentorial artery of the meningohypophyseal trunk in 26%. The distal half was supplied mainly by the branches from the inferolateral trunk. (3) In the region of Dorellos canal, the proximal part of the abducens nerve received branches from the dorsal meningeal artery. The middle and distal parts received branches from the inferolateral trunk. (4) The ophthalmic and proximal maxillary segments of the trigeminal nerve received branches from the inferolateral trunk. The medial part of ganglion received branches from inferolateral trunk and the tentorial artery. The middle part of it received branches from the inferolateral trunk. The lateral part of it received branches from either the inferolateral trunk or the middle meningeal artery. Conclusions　The inferolateral trunk play an important role in the blood supply of the intracavernous cranial nerves. We should preserve the blood supply to the cranial nerves during cavernous sinus surgery, thus minimizing postoperative cranial nerve deficits.