Reisch Robert, Vutskits László, Filippi Ronald, Patonay Lajos, Fries Georg, Perneczky Axel
Department of Neurosurgery, Johannes Gutenberg University, Mainz, Germany.
Neurosurg Rev. 2002 Jun;25(3):177-83. doi: 10.1007/s10143-001-0192-7.
In this publication, the authors describe the microanatomic topography of the entire paraclinoid area with respect to the paraclinoid segment of the internal carotid artery and its surrounding anatomical structures. Special attention was given to the borders of the paraclinoid area, cavernous sinus, arterial vessels, and cranial nerves passing through the region. The paraclinoid region was defined as a pyramid-formed space formed by the dural covering of the anterior clinoid process. The superior border is formed by the continuity of the anterior petroclinoid fold, anteriorly on the superior surface of the anterior clinoid process and medially in the direction of the diaphragma sellae. This dural sheet encircles the internal carotid artery and forms the so-called distal dural ring of the internal carotid artery. The medial border of the paraclinoid region is formed by the body of the sphenoid bone and the adjacent periosteal sheet. The inferior border is formed by a fibrous plate between the middle and anterior clinoid processes. This so-called proximal dural ring separates the venous compartments of the cavernous area from the paraclinoid area. The lateral border is formed by the lateral surface of the anterior clinoid process with its dural covering. The arterial supply of this region is provided by branches of the intracavernous carotid segment and the ophthalmic artery. The important nerves in close vicinity to the paraclinoidal area are the optic and the oculomotor nerves. Understanding and knowledge of the topographic anatomy of the paraclinoid area is essential for microsurgical exposure of this region.
在本出版物中，作者描述了整个鞍旁区域相对于颈内动脉鞍旁段及其周围解剖结构的微观解剖学形态。特别关注了鞍旁区域、海绵窦、动脉血管以及穿过该区域的颅神经的边界。鞍旁区域被定义为由前床突硬膜覆盖形成的金字塔形空间。上边界由岩前床突皱襞的连续性形成，在前方位于前床突上表面，向内侧沿鞍膈方向延伸。该硬膜片环绕颈内动脉并形成所谓的颈内动脉远侧硬膜环。鞍旁区域的内侧边界由蝶骨体和相邻的骨膜片形成。下边界由中床突和前床突之间的纤维板形成。这个所谓的近侧硬膜环将海绵窦区域与鞍旁区域的静脉腔分隔开。外侧边界由前床突及其硬膜覆盖的外侧表面形成。该区域的动脉供应由海绵窦段颈内动脉分支和眼动脉提供。鞍旁区域附近的重要神经是视神经和动眼神经。了解和掌握鞍旁区域的局部解剖学对于该区域的显微手术显露至关重要。
