Magnan P E, Branchereau A, Cannoni M
Service de Chirurgie Vasculaire des Hôpitaux sud. Hôpital Sainte Marguerite, Marseille, France.
J Cardiovasc Surg (Torino). 1992 May-Jun;33(3):372-9.
Internal carotid aneurysms at the base of the skull after blunt trauma are infrequent but their management is difficult, leading many surgeons to only attempt ligation. We report 2 cases presenting with high traumatic aneurysms, following motorcycle accidents. The 2 aneurysms underwent repair by a venous graft. The petrous portion of the carotid artery was approached and controlled by an ENT surgeon. This "infratemporal" approach was used exposing the facial nerve, combined with temporary anterior sub-luxation of the temporomaxillary joint to expose the lower part of the carotid canal which was opened up with a drill in order to control the carotid artery in the petrous canal. Both patients developed facial nerve palsies which improved within 3 months. Postoperative angiography showed patent vein grafts and the patients were doing well, without any symptoms 18 and 24 months later.
钝性创伤后颅底颈内动脉瘤并不常见，但治疗困难，导致许多外科医生仅尝试进行结扎。我们报告2例摩托车事故后出现的高位创伤性动脉瘤病例。这2例动脉瘤均采用静脉移植进行修复。耳鼻喉科医生通过入路并控制颈动脉的岩骨段。采用这种“颞下”入路暴露面神经，同时联合颞下颌关节临时前脱位以暴露颈动脉管下部，并用钻头打开该部位以控制岩骨段颈动脉。2例患者均出现面神经麻痹，但在3个月内有所改善。术后血管造影显示静脉移植通畅，患者情况良好，18个月和24个月后均无任何症状。
