本文選題：顯微解剖 + 經(jīng)下頜入路��； 參考：《南京醫(yī)科大學(xué)》2005年碩士論文

【摘要】：第一部分 顳下經(jīng)下頜入路顯露側(cè)顱底區(qū)的顯微解剖學(xué)研究 目的 詳盡了解顳下經(jīng)下頜入路顯露側(cè)顱底區(qū)的顯微解剖結(jié)構(gòu),為臨床應(yīng)用提供解剖學(xué)參數(shù),從而提高側(cè)、中顱底區(qū)溝通性腫瘤的手術(shù)療效,設(shè)計(jì)并進(jìn)行此項(xiàng)研究。 方法 選用成人尸頭10例(20側(cè)),模擬顳下經(jīng)下頜手術(shù)入路,解剖、觀察、測(cè)量相關(guān)結(jié)構(gòu),探求入路涉及的肌肉、神經(jīng)血管間的解剖關(guān)系。所得數(shù)據(jù)均經(jīng)統(tǒng)計(jì)學(xué)處理,以平均數(shù)±標(biāo)準(zhǔn)差(測(cè)量值范圍)的形式表示。 結(jié)果 面神經(jīng)額顳支走行于顳淺筋膜和顳深筋膜淺層之間或顳淺筋膜內(nèi)。顳下窩和翼腭窩血管神經(jīng)豐富,翼外肌占據(jù)著顳下窩的大部分空間。上頜動(dòng)脈是頸外動(dòng)脈兩終支中較大的一支,其顳下窩內(nèi)的走行可被分成下頜部、翼肌部和翼腭部三段,其中下頜部位于下頜關(guān)節(jié)囊下方20.4±1.7mm(16.8-23.4),翼肌部和翼腭部行程變異較大。翼靜脈叢有深淺兩部分,本研究觀察深部較為明顯。下頜神經(jīng)分主司運(yùn)動(dòng)的前外側(cè)股和主司感覺(jué)的后內(nèi)側(cè)股。莖突及其筋膜將咽旁間隙分為莖突前和莖突后間隙,后者容納頸內(nèi)靜脈、頸內(nèi)動(dòng)脈和Ⅸ,Ⅹ,Ⅺ,Ⅻ顱神經(jīng)。 結(jié)論 顳下經(jīng)下頜入路用于切除位于顳下窩、翼腭窩、咽旁間隙及中顱窩底的腫瘤,尤其是側(cè)、中顱底區(qū)巨大溝通性腫瘤。該入路暴露充分,涉及解剖復(fù)雜,系統(tǒng)全面地掌握相關(guān)解剖知識(shí)是應(yīng)用該入路的必要前提。
[Abstract]:The first part: microanatomical study on the exposure of lateral skull base area by subtemporal approach via mandibular approach Objective to investigate the microanatomical structure of lateral skull base by subtemporal and mandibular approach in order to provide anatomical parameters for clinical application and to improve the surgical efficacy of communicating tumors in lateral and middle skull base. Methods Ten cadaveric cadavers with 20 sides were used to simulate the subtemporal transmandibular approach, dissection, observe and measure the related structures, and explore the anatomical relationship between the muscles, nerves and vessels involved in the approach. The data were statistically processed and expressed as mean 鹵standard deviation (range of measured values). Results the frontotemporal branch of the facial nerve was located between the superficial temporal fascia and the superficial layer of the deep temporal fascia or within the superficial temporal fascia. The infratemporal fossa and pterygopalatine fossa are abundant in blood vessels and nerves. The maxillary artery is the larger of the two terminal branches of the external carotid artery. The path in the infratemporal fossa can be divided into three segments: the pterygoid muscle and the pterygopalatine. The mandible is located below the mandibular joint capsule 20.4 鹵1.7mm and 16.8-23.4m, and the distance between the pterygoid muscle and the pterygoid is more variable. The pterygoid venous plexus is deep and shallow. The mandibular nerve is divided into the anterolateral thigh of the main division motion and the posterior medial thigh of the main division sensation. The styloid process and its fascia divide the parapharyngeal space into the anterior-styloid space and the poststyloid space, the latter accommodating the internal jugular vein, the internal carotid artery and IX, 鈪，

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