本文選題：面神經(jīng) + 動眼神經(jīng)　； 參考：《河北聯(lián)合大學(xué)》2011年碩士論文

【摘要】：目的: 通過在10例國人尸頭標本上采用額顳眶顴入路,(其中灌注7例,未灌注3例;男性6例,女性4例)對動眼神經(jīng)及其周圍結(jié)構(gòu)觀察和測量,為臨床保護動眼神經(jīng)及利用動眼神經(jīng)周圍相關(guān)間隙提供解剖學(xué)依據(jù)和參考。 對象和方法: 1.應(yīng)用灌注有彩色硅膠的尸頭標本7例,未灌注3例模擬額顳眶顴入路逐層解剖,對顳區(qū)軟組織層次和動眼神經(jīng)及周圍血管、蛛網(wǎng)膜結(jié)構(gòu)進行精確測量和拍攝,觀測與動眼神經(jīng)相關(guān)間隙對顱底解剖結(jié)構(gòu)的顯露情況。 2.測量數(shù)據(jù)用SPSS13.0統(tǒng)計學(xué)軟件處理后,以x士s(最小值min～最大值max)表示。 結(jié)果: 1.面神經(jīng)顳支分為前、中、后三支,前、中支在跨越顴弓上緣處,位于顳淺動脈主干前約1cm處,耳屏前2.4cm( 1.8～3.2cm)處;面神經(jīng)顳支主要穿行于第Ⅰ、Ⅱ?qū)又緣|中。 2.池段動眼神經(jīng)和海綿竇上段動眼神經(jīng)周圍是蛛網(wǎng)膜匯集點,主要蛛網(wǎng)膜結(jié)構(gòu)有l(wèi)iequist膜和動眼神經(jīng)鞘;動眼神經(jīng)入口與前床突和后床突的距離分別為11.24±4.32(6.13～18.06)mm和5.43±1.41 (2.63～7.08)mm。 3.海綿竇段動眼神經(jīng)長、寬、高分別為16.52±3.08(12.86～20.09)mm、2.04±0.68(1.38～3.82)mm、1.53±0.46(1.06～1.94)mm;參與組成前內(nèi)側(cè)三角(Dolenc三角)、內(nèi)側(cè)三角(Hakuba三角)、旁內(nèi)側(cè)三角或Parkinson三角。 4.眶段動眼神經(jīng)穿過眶上裂中央?yún)^(qū),在入眶上裂前2～3mm處分為上、下2支;動眼神經(jīng)與眶上裂上壁、內(nèi)側(cè)壁和外側(cè)壁的距離分別為0.46士0.25(0.12～1.16)mm、1.78土0.55(0.48～3.10)mm和12.24士2.03(9.62～15.64)mm。 5.頸內(nèi)動脈-小腦幕三角位于頸內(nèi)動脈外側(cè)和顳葉基底部之間,內(nèi)側(cè)邊長為:8.23±2.87(5.76～11.03)mm,外側(cè)邊為7.24±1.87(5.32～9.62)mm,底邊為5.78±2.24(3.16～8.02)mm;動眼神經(jīng)外側(cè)間隙中可見蛛網(wǎng)膜結(jié)構(gòu)和小腦上動脈。 結(jié)論: 1.動眼神經(jīng)外側(cè)間隙在處理基底動脈及其分支動脈瘤時有一定的輔助應(yīng)用價值。 2.在海綿竇部,Parkinson三角和內(nèi)側(cè)三角聯(lián)合入路幾乎可顯露海綿竇的所有結(jié)構(gòu)和部位,因此臨床上多應(yīng)用這兩個處理海綿竇的病變。該區(qū)域手術(shù)對動眼神經(jīng)損傷率比較高。
[Abstract]:Objective:The oculomotor nerve and its surrounding structures were observed and measured in 10 cadavers of Chinese cadavers by frontotemporal orbital zygomatic approach (7 cases were perfused, 3 cases were not perfused, 6 cases were males and 4 cases were females).To provide anatomic basis and reference for clinical protection of oculomotor nerve and utilization of the space around oculomotor nerve.Objects and methods:1.Seven cadaver head specimens infused with color silica gel and 3 cases without simulated frontotemporal orbital zygomatic approach were dissected layer by layer to accurately measure and photograph the soft tissue level of temporal region, oculomotor nerve and surrounding vessels, arachnoid structure.The exposure of cranial base anatomical structure to the space related to oculomotor nerve was observed.2.The measured data were processed by SPSS13.0 statistical software and expressed as x + s (minimum min-max).Results:1.The temporal branches of the facial nerve were divided into anterior, middle and posterior branches. The anterior and middle branches were located about 1cm in front of the main trunk of superficial temporal artery and 2.4 cm (1.83.2cm) in front of the superficial temporal artery, and the temporal branch of facial nerve mainly passed through the first and second layers of fat pad.2.The oculomotor nerve in the cisternal segment and the oculomotor nerve in the superior cavernous sinus were surrounded by arachnoid junction, the main arachnoid structures were liequist membrane and oculomotor nerve sheath, the distance between the entrance of the oculomotor nerve and the anterior clinoid process and the posterior clinoid process was 11.24 鹵4.32(6.13~18.06)mm and 5.43 鹵1.41 鹵1.41 鹵2.63 ~ 7.08 mm. respectively.3.4.5.Conclusion:1.The lateral space of oculomotor nerve has some auxiliary application value in the treatment of basilar artery and its branches.2.In the cavernous sinus, Parkinson's triangle and medial triangle combined approach can reveal almost all structures and sites of cavernous sinus, so these two methods are often used in clinical treatment of cavernous sinus lesions.The rate of oculomotor nerve injury in this area is higher.
【學(xué)位授予單位】：河北聯(lián)合大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2011
【分類號】：R322

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