论文部分内容阅读
目的从应用解剖学入手,量化和微创化研究经岩骨后入路。方法在手术显微镜下,对20侧(10具)福尔马林固定的成人头颅标本进行颅底剖面的解剖测量;对6侧(3具)头颅标本模拟经岩骨后入路,进行入路全程解剖观察。结果确定了经岩骨后入路的骨窗后下界和入路行经的重要路标;观测了面神经管和迷路结构的解剖关系;明确了安全切除岩尖区骨质的范围。依据上述观测结果,模拟、验证经岩骨后入路,并提出改进方法。结论传统经岩骨后入路对岩尖区硬膜内结构的暴露范围有限,手术风险较大。通过量化、微创化研究经岩骨后入路的硬膜外骨切除操作,改进硬脑膜和小脑幕切开方法,明显扩大对岩尖区硬膜内结构的显露,确保手术的安全性。
Objective To begin with the application of anatomy, quantification and minimally invasive research by the petrous bone approach. Methods The skull base anatomy was performed on 20 sides (10) formalin-fixed adult skull specimens under a surgical microscope. Six (3) skull specimens were simulated by the posterior approach and followed Full anatomical observation. Results The lower boundary of the posterior bone window and the important signpost passed through the petrous aorta were determined. The anatomic relationship between the facial nerve canal and the lost structure was observed. The scope of bone removal was clearly identified. Based on the above observation results, we simulated and verified the transarticular approach and proposed an improved method. Conclusion The traditional posterior approach to petrous apex possesses a limited scope of exposure to the epidural structure in the petrous apex, and the surgical risk is high. Through quantitative and minimally invasive study of the epidural bone resection through the posterior petrous bone to improve the dural and tentorial incision methods, significantly expand the petrous apex dura mater structure revealed to ensure the safety of surgery.