Ebner F H, Roser F, Shiozawa T, Ruetschlin S, Kirschniak A, Koerbel A, Tatagiba M
Department of Neurosurgery, Eberhard-Karls-University, 72076 Tuebingen, Germany.
Eur J Surg Oncol. 2009 May;35(5):552-6. doi: 10.1016/j.ejso.2008.06.011. Epub 2008 Jul 24.
The present anatomic study investigates alternative draining pathways of the petrosal vein territory, which allow compensation in case of surgical sacrifice.
In eight (four formaldehyde fixed and four alcohol fixed) specimens the petrosal vein complex has been dissected and studied. Three heads have been selectively injected via the superior petrous sinus with colored silicon in two different colors. Thereafter the posterior fossa content was removed epidurally from the skull and further fixed in 4% formaldehyde. The nervous and vascular structures were dissected under microscopic control, measured and photographed. 3D-photographs were elaborated.
The petrosal vein was present in all cases and joined the superior petrous sinus always lateral to the trigeminal nerve as a single trunk. In the selectively injected specimens no passage of the colored silicon mixture to the contralateral venous brainstem territory could be discerned. However, the ipsilateral anastomoses to the deep supratentorial venous system--peduncular, anterolateral pontomesencephalic, lateral mesencephalic veins, and the tectal veins in connection with the pontotrigeminal vein--filled in all cases.
Although the present anatomical model does not reflect physiological aspects of vascular dynamics, we document an apparently compensatory venous blood drainage occurring via anastomotic pathways directed to the ipsilateral supratentorial venous system. These findings represent an interesting aspect for preoperative image-guided planning in cerebello-pontine angle surgery.
本解剖学研究旨在探究岩静脉区域的其他引流途径，以便在手术切除时实现代偿。
对八个标本（四个用甲醛固定，四个用酒精固定）的岩静脉复合体进行了解剖和研究。对三个头颅通过岩上窦选择性注入两种不同颜色的彩色硅。此后，从颅骨硬膜外移除后颅窝内容物，并进一步固定于4%甲醛中。在显微镜控制下对神经和血管结构进行解剖、测量和拍照。制作了三维照片。
所有病例均存在岩静脉，且总是作为单一主干在三叉神经外侧汇入岩上窦。在选择性注入的标本中，未发现彩色硅混合物流入对侧静脉脑干区域。然而，同侧与幕上深部静脉系统的吻合支——脚间静脉、脑桥中脑前外侧静脉、中脑外侧静脉以及与脑桥三叉静脉相连的顶盖静脉——在所有病例中均充盈。
尽管目前的解剖模型未反映血管动力学的生理方面，但我们记录到一种明显的代偿性静脉血引流，通过指向同侧幕上静脉系统的吻合途径发生。这些发现为桥小脑角手术的术前影像引导规划提供了一个有趣的方面。
