小脑脑桥角内窥镜手术的应用解剖

目的：探讨内窥镜在小脑脑桥角手术中的应用。方法：在内窥镜下对１５具成人尸头小脑脑桥角神经血管解剖结构进行观察，测量乙状窦后缘中点至各神经根的距离。结果：不同视角的内窥镜可以观察到因神经、血管襻及小脑绒球等遮挡而难以在手术显微镜下观察的神经根周围组织结构；乙状窦后缘中点至三叉神经根、面神经根、听神经根、舌咽神经根及内耳门后缘、颈动脉管内口后壁距离分别为３９．３６±２．０９ｍｍ、４０．９６±２．１１ｍｍ、３８．６５±１．７５ｍｍ、３５．８６±２．９３ｍｍ、３１．３８±１．６３ｍｍ、５２．７８±４．２４ｍｍ。结论：结合内窥镜用于小脑脑桥角手术可以提高手术的成功率，降低手术的危险性。所测得的数据为临床应用提供了参考。

ENDOSCOPIC ANATOMY OF THECEREBELLOPONTINE ANGLE

Objective: To explore the use of the endoscope in the cerebellopontine angle operation. Methods: The structure of nerve and vasculature in the cerebellopontine angle on 15 cadaver heads was observed. The distance from the central point of the posterior edge of the sigmoideus sinus to the roots of the nerve was measured. Results: The structure around the roots of the nerve sheltered by nerve, vasocular loop and cerebellar flocculus could be observed under the endoscope, while it could not be seen under the operation microscope. The distances from the central point of the posterior edge of the sigmoideus sinus to the roots of the trigeminal nerve, facial nerve, vestibulocochlear nerve, glossopharyngeal nerve, the posterior edge of the internal acoustic pore, and the internal aperture of carotid canal were 39.362.09mm, 40.962.11mm, 38.651.75mm, 35.862.93mm, 31.381.63mm, 52.784.24mm respectively. Conclusion: The use of the endoscope in the cerebellopontine angle operation improves the success rate and reduces the risk of failure. The data obtained may give useful information in the cerebellopontine angle operation under the endoscope.