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[枕下远外侧入路和耳后经颞入路对颈静脉孔区暴露的定量分析]

[Quantitative analysis of the exposure of suboccipital far-lateral approach and postauricular transtemporal approach to the jugular foramen region].

作者信息

Liu Qing, Yu Chun-jiang, Yuan Xian-rui, Yan Chang-xiang, Yang Jun, Yue Ying, Huang Yu-bao

机构信息

Department of Neurosurgery, Beijing Sanbo Fuxing Brain Hospital & Fuxing Hospital, Affiliated to the Capital University of Medical Sciences, Beijing 100038, China.

出版信息

Zhonghua Wai Ke Za Zhi. 2007 Apr 15;45(8):558-61.

Abstract

OBJECTIVE

To study the exposure of suboccipital far-lateral approach and postauricular transtemporal approach to the jugular foramen region based on quantitative measurements, and provide reliable anatomic data for selecting surgical approach individually and protecting the function of important structures.

METHODS

The complete approach of the suboccipital far-lateral approach and the postauricular transtemporal approach were reproduced in twelve (twenty-four sides) head-neck specimens of adults be fixed in 10% formalin. The exposure area to the jugular foramen region was obtained using a stereotactic device, and the length of exposure of the clivus and the trigeminal nerve were measured using a vernier caliper.

RESULTS

In the suboccipital far-lateral approach, the significant increase in exposure was noted after removal of the jugular process and partial resection of occipital condyle. In the postauricular transtemporal approach, the exposure increased significantly after complete retrolabyrinthine approach, partial labyrinthectomy and transcochlear approach.

CONCLUSIONS

Resection of jugular process is the key to expose the jugular foramen through the far-lateral approach. The infralabyrinthine approach and the partial labyrinthectomy approach are ideal approaches to expose the jugular foramen region laterally.

摘要

目的

基于定量测量研究枕下远外侧入路和耳后经颞入路对颈静脉孔区的显露情况,为个体化选择手术入路及保护重要结构功能提供可靠的解剖学数据。

方法

在12例(24侧)用10%甲醛固定的成人头颈标本上重现枕下远外侧入路和耳后经颞入路的完整手术过程。使用立体定向装置获取颈静脉孔区的显露面积,用游标卡尺测量斜坡和三叉神经的显露长度。

结果

在枕下远外侧入路中,切除颈静脉结节和部分枕髁后显露明显增加。在耳后经颞入路中,完全迷路后入路、部分迷路切除术和经耳蜗入路后显露显著增加。

结论

切除颈静脉结节是通过远外侧入路显露颈静脉孔的关键。迷路下入路和部分迷路切除术是从外侧显露颈静脉孔区的理想入路。

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