側(cè)方入路對(duì)頸靜脈孔區(qū)結(jié)構(gòu)不同顯露程度的解剖學(xué)研究
發(fā)布時(shí)間：2019-05-11 18:38
【摘要】：頸靜脈孔位于顳骨莖突的內(nèi)側(cè)偏前方,前部為顳骨巖部后下緣,后部為枕骨頸靜脈,圍繞乙狀竇巖下竇。左右兩側(cè)頸靜脈孔大小不等,通常較大。其大小、形態(tài)在不同的顱骨有不同差異,同一顱骨兩側(cè)不同,同一孔道顱內(nèi)端、顱外端亦不同。頸靜脈孔形態(tài)不規(guī)則,周圍與諸多結(jié)構(gòu)毗鄰且相互之間關(guān)系密切,眾多顱神經(jīng)和靜脈管腔穿行,位置深,解剖結(jié)構(gòu)復(fù)雜,手術(shù)常難以到達(dá),為重要的顱底通道。頸靜脈孔難以暴露因其位置深且周圍毗鄰迷路、耳蝸,IX-XI對(duì)腦神,頸內(nèi)動(dòng)、靜脈,椎動(dòng)脈等諸多重要結(jié)構(gòu),發(fā)生腫瘤時(shí)不僅累及神經(jīng)、血管,而且向周圍侵襲損害周圍結(jié)構(gòu),使得此區(qū)域病變手術(shù)切除難度巨大。 頸靜脈孔區(qū)腫瘤特性導(dǎo)致腫瘤臨床癥狀多樣,腫瘤可向周圍各個(gè)方向生長(zhǎng),形態(tài)多樣,侵及周圍組織結(jié)構(gòu)使得病變更加復(fù)雜。雖然不同學(xué)者對(duì)該區(qū)解剖結(jié)構(gòu)進(jìn)行了大量細(xì)致的研究為臨床工作提供了解剖學(xué)依據(jù),但因該區(qū)結(jié)構(gòu)的復(fù)雜性和研究角度的不同性,使得該區(qū)顯微解剖學(xué)資料任然不足。本課題擬通過(guò)6具12側(cè)成年國(guó)人頭顱濕性標(biāo)本模擬側(cè)方入路及其改良入路完成對(duì)頸靜脈孔及其周圍結(jié)構(gòu)的顯露,對(duì)同一區(qū)域不同顯露結(jié)構(gòu)進(jìn)行對(duì)比研究。旨在通過(guò)對(duì)頸靜脈孔區(qū)顯微解剖依據(jù)腫瘤生長(zhǎng)的部位、大小、侵及范圍以及綜合考慮患者聽(tīng)力狀況和后組顱神經(jīng)功能為前提,為術(shù)中在面聽(tīng)神經(jīng)、后組顱神經(jīng)功能保護(hù),減少并發(fā)癥的基礎(chǔ)上,盡可能徹底切除腫瘤提供解剖學(xué)依據(jù)。
[Abstract]:The jugular foramen lies in the anterior part of the styloid process of the temporal bone, the anterior part is the posterior inferior margin of the petrous part of the temporal bone, and the posterior part is the occipital jugular vein surrounding the inferior petrosal sinus of the sigmoid sinus. The size of the jugular foramen varies between the left and right sides, usually larger. Its size and shape are different in different skulls, different on both sides of the same skull, on the intracranial end of the same orifice, and on the extracranial end of the skull. Jugular foramen is irregular in shape, adjacent to many structures and closely related to each other. Many intracranial nerves and venous lumen pass through, the position is deep, the anatomical structure is complex, and the operation is often difficult to reach, so it is an important skull base channel. Jugular foramen is difficult to expose because of its deep position and adjacent labyrinth, cochlea, IX-XI to brain god, internal jugular artery, vein, vertebral artery and many other important structures, the occurrence of tumors not only involves nerves and blood vessels. Moreover, invasion and damage to the surrounding structure make it difficult to resect the lesion in this area. The tumor characteristics of jugular foramen region lead to various clinical symptoms of the tumor. The tumor can grow in various directions and the shape is diverse. The invasion of the surrounding tissue structure makes the lesion more complicated. Although different scholars have done a lot of detailed research on the anatomical structure of this area to provide the basis for clinical work, but because of the complexity of the structure and the different research angles, the microanatomical data in this area are still insufficient. The purpose of this study was to complete the exposure of jugular foramen and its surrounding structures by simulated lateral approach and modified approach in 6 wet specimens of 12 adult Chinese heads, and to compare the different exposure structures in the same area. In order to protect the function of facial auditory nerve and posterior cranial nerve during operation, the microanatomy of jugular foramen area was based on the location, size, invasion range of the tumor and comprehensive consideration of the patient's hearing condition and cranial nerve function in the posterior group. On the basis of reducing complications, complete resection of the tumor as far as possible provides anatomical evidence.
【學(xué)位授予單位】：蘭州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R322.12
本文編號(hào)：2474753
[Abstract]:The jugular foramen lies in the anterior part of the styloid process of the temporal bone, the anterior part is the posterior inferior margin of the petrous part of the temporal bone, and the posterior part is the occipital jugular vein surrounding the inferior petrosal sinus of the sigmoid sinus. The size of the jugular foramen varies between the left and right sides, usually larger. Its size and shape are different in different skulls, different on both sides of the same skull, on the intracranial end of the same orifice, and on the extracranial end of the skull. Jugular foramen is irregular in shape, adjacent to many structures and closely related to each other. Many intracranial nerves and venous lumen pass through, the position is deep, the anatomical structure is complex, and the operation is often difficult to reach, so it is an important skull base channel. Jugular foramen is difficult to expose because of its deep position and adjacent labyrinth, cochlea, IX-XI to brain god, internal jugular artery, vein, vertebral artery and many other important structures, the occurrence of tumors not only involves nerves and blood vessels. Moreover, invasion and damage to the surrounding structure make it difficult to resect the lesion in this area. The tumor characteristics of jugular foramen region lead to various clinical symptoms of the tumor. The tumor can grow in various directions and the shape is diverse. The invasion of the surrounding tissue structure makes the lesion more complicated. Although different scholars have done a lot of detailed research on the anatomical structure of this area to provide the basis for clinical work, but because of the complexity of the structure and the different research angles, the microanatomical data in this area are still insufficient. The purpose of this study was to complete the exposure of jugular foramen and its surrounding structures by simulated lateral approach and modified approach in 6 wet specimens of 12 adult Chinese heads, and to compare the different exposure structures in the same area. In order to protect the function of facial auditory nerve and posterior cranial nerve during operation, the microanatomy of jugular foramen area was based on the location, size, invasion range of the tumor and comprehensive consideration of the patient's hearing condition and cranial nerve function in the posterior group. On the basis of reducing complications, complete resection of the tumor as far as possible provides anatomical evidence.
【學(xué)位授予單位】：蘭州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R322.12
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