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目的:探讨乙状窦后-内听道上入路中岩骨磨除的安全性及术中解剖学标志。方法:在头颅标本上模拟乙状窦后-内听道上入路磨除内听道上结节,然后自中颅底测量骨窗与重要结构的距离。结果:中颅底骨窗与颈内动脉C5、C6段及外展神经的最短距离依次为:(2.72±2.31)mm,(2.41±1.53)mm和(2.89±1.90)mm。6例骨窗前缘达颈内动脉C5段,无一侧骨窗外侧边达颈内动脉C6段。结论:内听道上结节向前外侧可安全磨除,向前内侧磨除可能损伤颈内动脉C5段。由于解剖学变异,术中应综合判定骨质磨除的前界,防止重要结构损伤。
Objective: To investigate the safety and intraoperative anatomy of the petroclival removal in the posterior-sigmoid sinus approach. METHODS: After the sigmoid sinus was simulated on the skull specimens, the intra-ocular sphincter was ablated and the distance between the bone window and the important structure was measured from the mid-skull base. Results: The shortest distance between the medial skull base window and C5, C6 segments of the internal carotid artery and abducens nerve were (2.72 ± 2.31) mm, (2.41 ± 1.53) mm and (2.89 ± 1.90) mm, respectively. 6 cases of the leading edge of the internal carotid artery C5 carotid artery, no side outside the window of the carotid artery C6 segment. Conclusion: The nodal nodules can be safely abraded to the anteromedial side, and the anterior medial ablation may damage the C5 segment of the internal carotid artery. Due to anatomic variations, intraoperative should be comprehensively determine the boundaries of bone removal, to prevent damage to the important structures.