【摘要】：1.內(nèi)鏡經(jīng)鼻-蝶入路至顱底及巖斜區(qū)的解剖研究：目的了解經(jīng)鼻-蝶入路到達(dá)中后顱窩及巖斜區(qū)的一些解剖標(biāo)志和它們的相對關(guān)系方法4例8側(cè)甲醛固定后的完整成人尸頭標(biāo)本固定于特制三釘頭架，將神經(jīng)內(nèi)鏡插入鼻腔，模擬經(jīng)鼻入路到達(dá)巖斜區(qū)手術(shù)結(jié)果測量到同側(cè)鼻孔從鼻小柱測量到Meckle腔距離73.1mm±2.67mm，角度12.65±2.16°；對側(cè)鼻孔從鼻小柱測量到Meckle腔距離77.9mm±3.4mm，角度18.8±0.8°同側(cè)鼻孔從鼻小柱測量到頸內(nèi)動(dòng)脈海綿竇段前曲段距離75.8mm±3.19mm，，前曲段與中線結(jié)構(gòu)的距離9.1mm±1.2mm結(jié)論巖斜區(qū)有眾多解剖標(biāo)志及重要的結(jié)構(gòu)如頸內(nèi)動(dòng)脈等，了解及熟悉該區(qū)域的顯微解剖對手術(shù)成功與否至關(guān)重要 2. Meckel腔的應(yīng)用解剖研究：目的詳細(xì)的了解Meckel腔及其毗鄰結(jié)構(gòu)的三維關(guān)系方法成人4例（8側(cè)）完整經(jīng)10%formalin固定后頭顱濕標(biāo)本分別逐一從眉弓上約0.5cm處連線到枕外粗隆正上方1.5cm鉆孔后用線鋸鋸開顱頂蓋骨，從靠近大腦腳位置切除整個(gè)端腦及間腦部分并移除顱骨腔內(nèi)，使兩側(cè)之三叉神經(jīng)和它的分支（V1V1V3） Meckel腔等得以顯露，顱底置于顯微鏡下放大后觀察同時(shí)測量記錄毗鄰相關(guān)結(jié)構(gòu)的形態(tài)大小和距離結(jié)果三叉神經(jīng)孔的高度我們的結(jié)果平均是3.08mm±1.29mm，長度我們的結(jié)果平均是7.64mm±1.35mm，我們的研究發(fā)現(xiàn)三叉神經(jīng)孔位于內(nèi)聽道內(nèi)上約9.82mm±1.51mm，三叉神經(jīng)孔在外展神經(jīng)外上方距Dorello管開口9.5mm±0.98mm，三叉神經(jīng)孔距離巖骨弓狀隆起約16.37mm±1.43mm,距離三叉神經(jīng)感覺根和運(yùn)動(dòng)根由腦干發(fā)出處11.30mm±1.86mm，距滑車神經(jīng)與小腦幕邊緣相交處約5.32mm±1.33mm結(jié)論Meckel腔和周圍重要的毗鄰結(jié)構(gòu)的三維空間關(guān)系及顯微解剖架構(gòu)知識是顱底病變手術(shù)成功實(shí)施的核心知識
[Abstract]:1. Anatomical study of endoscopic transsphenoidal approach to skull base and petroclival region: objective to understand some anatomic markers of transsphenoidal approach to the middle posterior cranial fossa and petroclival region and their relative relationship. The adult cadaveric head is fixed on a special triple-nailed head frame. The nerve endoscopy was inserted into the nasal cavity, and the results of simulated transnasal approach to the petroclival region showed that the distance from the column of the nose to the Meckle cavity was 73.1mm 鹵2.67 mm, and the angle was 12.65 鹵2.16 擄. The distance between the contralateral nostril and the Meckle cavity is 77.9mm 鹵3.4 mm, the angle is 18.8 鹵0.8 擄from the nasal column to the anterior curvature of the cavernous sinus segment of the internal carotid artery, and the distance between the anterior convoluted segment and the midline structure 9.1mm 鹵1.2mm conclusion there are many anatomical markers and weight in the diagonal region. The desired structure, such as the internal carotid artery, Understanding and familiarizing the microanatomy of the area is essential to the success of the operation. Applied Anatomical study of Meckel cavity: objective to understand the three-dimensional relationship between Meckel cavity and its adjacent structures in detail methods four adult cases (8 sides) of head wet specimens fixed by 10%formalin were respectively connected to the extraoccipital protuberance from about 0.5cm above the eyebrow arch one by one. 1.5cm was used to saw the cranio-parietal bone with a wire saw. The entire endencephalon and diencephalon were removed from the near foot of the brain and the cranial cavity was removed so that the bilateral trigeminal nerve and its branch (V1V1V3) Meckel cavity were exposed. The skull base was magnified under a microscope, and the size and distance of the adjacent structures were measured simultaneously. The height of the trigeminal foramen was 3.08mm 鹵1.29 mm on average, and the average length of our results was 7.64mm 鹵1.35 mm. Our study found that the average height of the trigeminal foramen was 1.35 mm. The trigeminal foramen is located about 9.82mm 鹵1.51 mm above the internal auditory canal, 9.5mm 鹵0.98 mm above the Dorello canal, 16.37mm 鹵1.43 mm from the arcuate protuberance of the petrosal bone, 11.30mm 鹵1.86 mm from the sensory root and motor root of the trigeminal nerve from the brainstem, and a distance between the trigeminal nerve foramen and the opening of the Dorello canal, and the distance between the trigeminal foramen and the arcuate protuberance of the petrosal bone. About 5.32mm 鹵1.33mm at the intersection of the cerebellar tentorium and the motor nerves conclusion the knowledge of the three-dimensional spatial relationship between the Meckel cavity and the important adjacent structures around the cerebellum and the knowledge of the microanatomical structure are the core knowledge of the successful operation of the skull base disease.
【學(xué)位授予單位】：第四軍醫(yī)大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R739.4

【參考文獻(xiàn)】

相關(guān)期刊論文 前1條

1 張秋航;孔鋒;嚴(yán)波;倪志立;;經(jīng)鼻內(nèi)鏡斜坡脊索瘤和脊索肉瘤的外科治療[J];中國微侵襲神經(jīng)外科雜志;2006年10期

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