本文選題：Kawase入路 + 虛擬現(xiàn)實(shí)�。� 參考：《中國臨床解剖學(xué)雜志》2017年04期

【摘要】：目的在虛擬現(xiàn)實(shí)建�；A(chǔ)上探討Kawase入路顯微解剖特征。方法 15例尸體頭顱CT和MRI影像數(shù)據(jù)用于構(gòu)建顱底虛擬現(xiàn)實(shí)三維解剖模型。以開顱和磨除巖骨的標(biāo)志點(diǎn)連線為軸線作出圓柱模擬Kawase入路手術(shù)路徑。觀察和測量兩種方向手術(shù)路徑中解剖結(jié)構(gòu)顯露情況。結(jié)果 Kawase入路路徑1包含巖上竇,路徑終點(diǎn)為三叉神經(jīng)出腦干處的腦橋,包含部分三叉神經(jīng)和小腦上動(dòng)脈。路徑2包含巖上竇、巖下竇和基底竇,之后于腦橋腹側(cè)依次經(jīng)過同側(cè)三叉神經(jīng)、同側(cè)展神經(jīng)、基底動(dòng)脈、對(duì)側(cè)展神經(jīng)和對(duì)側(cè)三叉神經(jīng),路徑2終點(diǎn)為路徑圓柱軸線與對(duì)側(cè)三叉神經(jīng)根的交點(diǎn)。路徑2中所測手術(shù)路徑、路徑中骨性結(jié)構(gòu)、腦干、動(dòng)脈結(jié)構(gòu)、靜脈結(jié)構(gòu)、巖淺大神經(jīng)和同側(cè)三叉神經(jīng)體積均大于路徑1中所測數(shù)據(jù),差異有統(tǒng)計(jì)學(xué)意義。操作方向1和2路徑中包含顳葉體積差異無統(tǒng)計(jì)學(xué)意義。結(jié)論 Kawase三角形成一個(gè)手術(shù)窗口,改變經(jīng)過窗口的路徑方向時(shí),路徑操作范圍隨之改變。經(jīng)過顳骨顴突根部上緣的路徑更有助于顯露腦干腹側(cè)。
[Abstract]:Objective to explore the microanatomical features of Kawase approach based on virtual reality modeling. Methods CT and MRI images of 15 cadaveric heads were used to construct virtual reality 3D anatomical model of skull base. Using the line of mark point of craniotomy and petrous bone grinding as axis, the surgical path of Kawase approach was simulated by cylinder. To observe and measure the exposure of anatomical structure in two directions. Results the Kawase pathway 1 contained the superior petrosal sinus, and the end point was the pons of the trigeminal nerve at the brainstem, including part of the trigeminal nerve and the superior cerebellar artery. Route 2 included the superior petrosal sinus, inferior petrosal sinus and basal sinus, and then passed through ipsilateral trigeminal nerve, ipsilateral abductive nerve, basilar artery, contralateral abducent nerve and contralateral trigeminal nerve at the ventral side of the pontine. The end point of path 2 is the intersection of the axis of the path cylinder and the contralateral trigeminal nerve root. The volume of the surgical pathway, the bone structure, the brain stem, the arterial structure, the venous structure, the superficial petrosal nerve and the ipsilateral trigeminal nerve in path 2 were larger than those in path 1. The difference was statistically significant. There was no significant difference in temporal lobe volume between pathways 1 and 2. Conclusion the Kawase triangle forms an operative window. When the path direction is changed, the operating range of the path changes. The pathway through the superior edge of the zygomatic process of the temporal bone is more helpful in exposing the ventral side of the brain stem.
【作者單位】： 廈門醫(yī)學(xué)院基礎(chǔ)醫(yī)學(xué)系;首都醫(yī)科大學(xué)附屬北京天壇醫(yī)院北京市神經(jīng)外科研究所;解放軍第三O九醫(yī)院神經(jīng)外科;
【基金】：首都衛(wèi)生發(fā)展科研專項(xiàng)基金(首發(fā)2014-4-5073)
【分類號(hào)】：R322;R651.1

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