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  本文選題：經(jīng)口咽入路　切入點：枕骨大孔擴大術(shù)　出處：《中南大學》2010年碩士論文

【摘要】： 目的：通過對枕骨斜坡骨性結(jié)構(gòu)及周圍毗鄰關(guān)系的解剖學測量,為經(jīng)口咽入路行枕骨大孔擴大術(shù)提供詳盡的解剖學依據(jù)。 方法：1、選取成人干燥顱骨標本40具,10具為正中矢狀剖面,30具為水平剖面。分別測量以下內(nèi)容：斜坡顱底內(nèi)面、顱底外面的長度；斜坡咽結(jié)節(jié)處寬度、斜坡最小厚度、中部厚度和最大厚度；斜坡與水平面的夾角；頸動脈管外口內(nèi)緣、頸靜脈孔內(nèi)外口內(nèi)緣、破裂孔內(nèi)外口內(nèi)緣、舌下神經(jīng)內(nèi)外口內(nèi)緣、寰枕關(guān)節(jié)內(nèi)緣與斜坡中線的距離。2、選取完整頭頸部標本20具,15具行正中矢狀切面,5具行水平切面,分別進行解剖,觀察斜坡與周圍血管神經(jīng)的毗鄰關(guān)系。 結(jié)果：1、斜坡顱底內(nèi)面長40.1±2.5mm,斜坡顱底外面長28.2±3.1mm,斜坡中部寬度18.8±2.5mm,斜坡最小厚度6.8±2.3mm,斜坡中部厚度9.8±2.2mm,斜坡最大厚度11.5±1.7mm,咽結(jié)節(jié)至枕骨大孔前緣距離12.8±1.5mm。2、斜坡與水平面的夾角46.8±4.5°。3、頸動脈管外口內(nèi)緣距離斜坡中線26.1±3.1mm,頸靜脈孔內(nèi)口內(nèi)緣距離斜坡中線21.8±2.5mm,頸靜脈孔外口內(nèi)緣距離斜坡中線25.1±2.7mm,破裂孔內(nèi)口內(nèi)緣距離斜坡中線10.5±2.9mm,破裂孔外口內(nèi)緣距離斜坡中線11.8±2.5mm,舌下神經(jīng)管內(nèi)口內(nèi)緣距離斜坡中線13.8±2.3mm,舌下神經(jīng)管外口內(nèi)緣距離斜坡中線21.1±2.3mm,寰枕關(guān)節(jié)內(nèi)緣距離斜坡中線10.5±2.3mm。4、斜坡上部距離后方基底動脈7.6±1.0mm,距離后方腦橋8.3±1.2mm,斜坡中部距離后方延髓腦橋溝13.5±1.7mm,斜坡下部距離后方延髓6.5±0.8mm。5、斜坡上部與后方硬腦膜之間間隙為1.8±0.2mm,斜坡中部與后方硬腦膜之間間隙為1.3±0.1mm,斜坡下部與后方硬腦、脊膜之間間隙為1.3±0.1mm。6、枕骨大孔前緣距離椎-基底動脈匯合處15.7±2.5mm。7、兩側(cè)椎動脈呈基本對稱的“人”字形匯合成基底動脈,椎動脈在枕骨大孔水平距離中線4.5±0.9mm,在枕骨大孔上方0.5cm水平距離中線3.2±0.7mm,在枕骨大孔上方1cm水平距離中線2.5±0.8mm,在枕骨大孔上方1.5cm水平距離中線1.5±0.8mm。8、在斜坡開骨窗的寬度為15mm,高度為10mm,深度為6mm,可以滿足經(jīng)口咽入路枕骨大孔擴大術(shù)的要求,并有可靠的安全性。 結(jié)論：本研究通過對枕骨斜坡骨性結(jié)構(gòu)及周圍毗鄰關(guān)系的測量與觀察,為臨床行經(jīng)口咽入路枕骨大孔擴大術(shù)提供了一定的解剖學依據(jù)。
[Abstract]:Objective: to provide anatomic basis for occipital foramen enlargement via oropharyngeal approach by anatomical measurement of the osseous structure of the occipital Clivus and its adjacent relationship.Methods: one, 40 adult dry skull specimens were selected. 10 of them were median sagittal profile and 30 were horizontal sections.The following contents were measured respectively: the internal surface of the slope skull base, the length of the skull base outside, the width of the Clivus pharynx nodule, the minimum thickness of the slope, the middle thickness and the maximum thickness, the angle between the slope and the horizontal plane, the inner margin of the external orifice of the carotid artery,The internal margin of internal and external orifice of jugular foramen, the inner margin of internal and external orifice of ruptured foramen, the inner margin of hypoglossal nerve and the distance between the inner margin of atlanto-occipital joint and the middle line of Clivus.To observe the relationship between Clivus and peripheral blood vessels and nerves.Results the mean length of the skull base of the slope was 40.1 鹵2.5mm, the outer length of the base of the slope was 28.2 鹵3.1mm, the width of the middle slope was 18.8 鹵2.5mm, the minimum thickness of the slope was 6.8 鹵2.3 mm, the thickness of the middle slope was 9.8 鹵2.2 mm, the maximum thickness of the slope was 11.5 鹵1.7 mm, the distance between the pharyngeal nodule and the anterior margin of the foramen magnum of the occipital bone was 12.8 鹵1.5 mm 路2, and the angle between the slope and the horizontal plane was 46.8 鹵4.5 擄路3.The inner edge of the external orifice of the carotid artery is 26.1 鹵3.1 mm away from the middle line of the slope, the inner edge of the internal orifice of the jugular foramen is 21.8 鹵2.5 mm from the middle line of the slope, the inner edge of the external orifice of the jugular foramen is 25.1 鹵2.7 mm from the middle line of the slope, the inner edge of the internal orifice of the ruptured hole is 10.5 鹵2.9 mm from the middle line of the slope, and the inner edge of the external orifice of the ruptured hole isThe distance from the middle part to the posterior medullary pons sulcus was 13.5 鹵1.7 mm, the distance from the lower part of the Clivus to the posterior medulla was 6.5 鹵0.8 mm 路5, the space between the upper Clivus and the posterior dura mater was 1.8 鹵0.2 mm, the gap between the middle Clivus and the posterior dura was 1.3 鹵0.1 mm, and the distance between the lower Clivus and the posterior dura was 1.3 鹵0.1 mm.The space between meninges was 1.3 鹵0.1mm 路6, and the distance between foramen magnum and basilar artery was 15.7 鹵2.5mm.The vertebral artery is 4.5 鹵0.9mm above the foramen magnum, 3.2 鹵0.7mm above the foramen magnum, 2.5 鹵0.8mm above the foramen magnum, 1.5 鹵0.8mm above the foramen magnum, 1.5 鹵0.8mm.8.15mm in height, 10mm in height, and 6mm in depth can meet the requirements of transoropharyngeal approach for the enlargement of the foramen magnum of the occipital bone.And have reliable safety.Conclusion: this study provides anatomic basis for clinical operation of occipital foramen magnum through oropharynx approach by measuring and observing the structure of occipital Clivus and its adjacent relationship.
【學位授予單位】：中南大學
【學位級別】：碩士
【學位授予年份】：2010
【分類號】：R651.1;R322

【參考文獻】

相關(guān)期刊論文 前10條

1 曹正霖,鐘世鎮(zhèn),劉景發(fā),黃文華,趙衛(wèi)東,李鑒軼,肖進;經(jīng)口入路齒狀突切除術(shù)對枕頸部穩(wěn)定性的影響[J];廣東醫(yī)學;2002年12期

2 陳新成;劉寧;朱風儀;趙春生;周明衛(wèi);蔣健;駱慧;;內(nèi)鏡下經(jīng)口咽入路至顱頸交界應用解剖學研究[J];解剖學研究;2005年04期

3 畢艷華;武江;;巖斜區(qū)病變的手術(shù)入路[J];河北醫(yī)藥;2007年01期

4 艾福志,尹慶水,王智運,夏虹,吳增暉;經(jīng)口咽前入路寰樞椎手術(shù)的解剖學研究[J];解放軍醫(yī)學雜志;2004年03期

5 朱海波,賈連順,孫啟全,許濤,閻明,寇庚;寰椎測量及臨床意義[J];解剖學雜志;1997年06期

6 苗驚雷;張朝躍;吳松;詹瑞森;張克祥;;內(nèi)窺鏡下經(jīng)口咽入路手術(shù)治療先天性顱底凹陷癥[J];頸腰痛雜志;2006年04期

7 黃安煬,劉運生,王延金;前入路的斜坡側(cè)壁顯微解剖研究與臨床應用[J];中華神經(jīng)外科疾病研究雜志;2003年02期

8 楊衛(wèi)忠,梁日生,石松生,張國良,劉才興,倪天瑞,陳建屏,林毅興;巖斜坡區(qū)及其手術(shù)入路的顯微解剖[J];中國耳鼻咽喉顱底外科雜志;1997年02期

9 秦軍,李新建,王輝,黃寬明,雷軍榮,何躍,涂漢軍,王倫長;神經(jīng)內(nèi)鏡技術(shù)的臨床應用[J];中國臨床神經(jīng)外科雜志;2005年03期

10 王繼群，許庚，卜國鉉;蝶竇外側(cè)壁的應用解剖[J];中華耳鼻咽喉科雜志;1994年03期

，

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