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目的为颅底外科提供Dorello管区的解剖学资料。方法 50例头颅标本进行血管灌注红、蓝乳胶或硅橡胶,对Dorello管区的构成、毗邻关系、内容物等进行观察和测量。对岩斜段展神经进行苏木精-伊红染色,研究该段展神经硬脑膜鞘的构成。结果 Dorello管由Gruber韧带、颞骨岩部尖端、上斜坡外缘构成,管内走行脑膜背侧动脉、展神经及其硬脑膜鞘。展神经硬脑膜鞘由硬脑膜和蛛网膜构成。Gruber韧带可以分为6型:Y-型,蝴蝶型,三角型,镰型,爪型和复干(条索状)型。展神经存在多种变异,复干型展神经出现率为16%,双侧都为复干型展神经的出现率为5%。展神经在Dorello管区出现转折,按转折的程度分为:重型(<120°)占60%(60侧),中型(120°~150°)占36%(36侧),轻型(150°~180°)占4%(4侧)。结论Dorello管区结构复杂,展神经变异多,对Dorello管区的研究有助于在手术中减少神经、血管的损伤,同时阐明展神经损伤的机理。
Objective To provide anatomic data of Dorello’s duct for skull base surgery. Methods 50 cases of cranial specimens were perfused with red, blue latex or silicone rubber, and the structures, adjacent relations and contents of Dorello area were observed and measured. Hematoxylin-eosin staining was performed on the petroclival extensor nerve to study the constitution of the dural sheath in this segment. Results The Dorello tube consisted of the Gruber ligament, the tip of the petrous bone and the outer edge of the upper slope, and the dural canal dorsal artery, the dorsal nerve and the dural sheath. Exhibition nerve dural sheath by the dura and arachnoid composition. Gruber ligaments can be divided into 6 types: Y-type, butterfly type, triangular type, sickle type, claw type and complex type (cord-like). There are many variations in the development of nerve, complex dry type of nerve development rate was 16%, both sides of the complex type of nerve development rate was 5%. The development of the dorsal nerve in the Dorello area was divided into 60% (60 sides) of heavy (<120 °), 36% (36 sides) of middle (120 ° ~ 150 °), 150 ° ~ 180 °) accounted for 4% (4 sides). Conclusions Dorello’s anatomical structure is complex and the number of nerve changes is variable. The study on Dorello’s duct area can help to reduce the damage of nerves and blood vessels during operation, and clarify the mechanism of nerve damage.