本文選題：咽旁間隙　切入點：經(jīng)口入路　出處：《局解手術學雜志》2016年06期

【摘要】：目的觀察內鏡下經(jīng)口入路咽旁間隙手術的解剖恒定標志,為處理咽旁間隙病變、提高手術成功率提供依據(jù)。方法對2015年1月至2015年9月獲得的10具新鮮尸頭進行CT多平面重建及三維重建,觀察咽旁間隙等咽旁結構,然后應用內窺鏡,于口內行內鏡輔助咽旁間隙解剖。結果 CT圖像上,極低密度的鼻咽向后外側延伸形成咽隱窩,咽旁間隙位于咽隱窩的外側,呈前窄后寬的低密度三角形陰影,翼內肌、翼外肌、咬肌、顳肌位于咽旁間隙的外側,呈中密度陰影,莖突位于咽旁間隙的前部陰影,咽旁間隙后部頸內動脈呈中密度陰影。咽旁間隙內血管、神經(jīng)顯影不清晰。莖突位于顱底顳骨鼓部下,長(24.98±2.01)mm,咽旁間隙內結構均位于莖突及其周圍深肌面,如莖突外側有頸外動脈、面神經(jīng)及乳突,莖突根部的內側有頸靜脈孔及舌下神經(jīng)管外口,前內方有頸動脈管外口、棘孔和卵圓孔,后方有莖乳孔。左右側莖突根部到周圍毗鄰組織結構的距離比較,差異無統(tǒng)計學意義(P0.05)。除莖突根部至莖乳孔外,男性莖突根部到周圍毗鄰組織結構的距離均大于女性,差異具有統(tǒng)計學意義(P0.05)。結論內鏡輔助下經(jīng)口入路咽旁間隙手術以莖突等作為解剖學標志,以莖突到毗鄰解剖結構的距離為參考,有助于咽旁間隙周圍神經(jīng)、血管等的尋找和辨認。
[Abstract]:Objective to observe the anatomical constant marks of endoscopic parapharyngeal space operation through oral approach, and to provide the basis for the treatment of parapharyngeal space disease and the improvement of surgical success rate.Methods CT multiplanar reconstruction and 3D reconstruction were performed on 10 fresh cadaveric heads from January 2015 to September 2015. The parapharyngeal space and other parapharyngeal structures were observed. Then endoscopic anatomy of the parapharyngeal space was performed by endoscope.Results on CT images, the extremely low density nasopharynx extended to the posterolateral side to form a pharyngeal recess, and the parapharyngeal space was located on the lateral side of the pharyngeal recess, with a low density triangle shadow of anterior narrow posterior width, medial pterygoid muscle, lateral pterygoid muscle and masseter muscle.The temporal muscle was located on the lateral side of the parapharyngeal space with medium density shadow, the styloid process in the anterior part of the parapharyngeal space and the posterior internal carotid artery in the parapharyngeal space.The vessels and nerves in the parapharyngeal space were not clear.The styloid process is located under the tympanic part of the skull base and 24.98 鹵2.01mm. the structure of the parapharyngeal space is located in the styloid process and its surrounding deep muscle surface, such as the external carotid artery, facial nerve and mastoid outside the styloid process, the medial foramen jugular vein and the external orifice of the sublingual nerve duct in the root of the styloid process.There are external orifice of carotid artery, foramen spinosus and foramen ovale in anterior and inner side, and caulomastoid foramen in the rear.There was no significant difference in the distance between the right and left stem process root and adjacent tissue structure (P 0.05).Except for the stem process root to the stem mammary foramen, the distance from the stem process root to the adjacent tissue structure of the male was larger than that of the female, and the difference was statistically significant (P 0.05).Conclusion Endoscope-assisted parapharyngeal space surgery with styloid process as anatomic marker and the distance from styloid process to adjacent anatomical structure as reference is helpful for the search and identification of peripheral nerves and blood vessels in parapharyngeal space.
【作者單位】： 深圳市龍華新區(qū)中心醫(yī)院耳鼻咽喉科;
【基金】：深圳市科技計劃項目(GCYG20150402140827355)
【分類號】：R762;R322

【參考文獻】

相關期刊論文 前4條

1 桑建中;婁衛(wèi)華;張亞民;;咽旁間隙腫瘤的診斷及手術入路選擇[J];臨床耳鼻咽喉頭頸外科雜志;2011年21期

2 吳芹;陳燕萍;徐[?;劉彩霞;;咽旁間隙多形性腺瘤與神經(jīng)鞘瘤的影像鑒別診斷[J];臨床放射學雜志;2011年08期

3 田文棟;李湘平;李丹鳳;劉雄;林少雄;梁勇;;咽旁間隙良性腫瘤的影像學特征及經(jīng)口手術進路分析[J];臨床耳鼻咽喉頭頸外科雜志;2010年21期

4 付升旗;王華;苗瑩瑩;范錫印;陶晶;岳學強;歐陽鈞;;側顱底的矢狀和冠狀斷層解剖及臨床意義[J];中國臨床解剖學雜志;2010年05期

相關博士學位論文 前1條

1 王曉彬;經(jīng)口內鏡輔助咽旁間隙臨床應用解剖及咽旁間隙腫瘤內鏡輔助經(jīng)口內入路切除術的臨床研究[D];山東大學;2014年

【共引文獻】

相關期刊論文 前10條

1 孫U，

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