Department of Neurosurgery, Clinical Medical College, Yangzhou University, Yangzhou, Jiangsu Province, China.
J Clin Neurosci. 2011 May;18(5):678-82. doi: 10.1016/j.jocn.2010.08.031.
We aimed to quantitate the exposure of the petroclival area after partial removal of the occipital condyle (OC) and tuberculum jugular (JT) using the far-lateral keyhole approach. Navigation data were obtained for six cadaveric heads, and the OC and jugular tubercle were outlined with different colours. After the retro-condylar keyhole approach was performed, 1/3 and then 1/2 of the OC and then the JT were resected stepwise using neuronavigation. Simultaneously, anatomic structures were observed and the lateral visual field angle (LVFA), exposed clival area and surgical freedom were measured. The mean ± standard deviation (SD) of the LVFA were: 39.2 ± 3.29° (before drilling the OC); 51.46 ± 2.45° (1/3 of the OC drilled); and 57.52 ± 2.66° (1/2 of the OC drilled); these values were significantly different (p<0.01). Exposure of the petroclival area increased significantly after JT removal (p<0.01), whereas surgical freedom increased significantly after removal of both partial OC and JT (p<0.05).We concluded that in the far-lateral keyhole approach, the LVFA is increased by partial drilling of the OC; the middle clivus is further exposed following JT drilling, and surgical freedom is improved significantly after partial removal of the OC and JT.
我们旨在通过远外侧锁孔入路定量分析部分切除枕髁（OC）和颈静脉结节（JT）后对岩斜区的显露。对 6 具尸体头颅进行了导航数据采集，并使用不同颜色勾勒出 OC 和颈静脉结节。完成寰枢后锁孔入路后，使用神经导航逐步切除 OC 的 1/3 和 1/2，然后切除 JT。同时观察解剖结构，测量外侧视野角（LVFA）、显露的斜坡区和手术自由度。LVFA 的平均值 ± 标准差（SD）分别为：39.2 ± 3.29°（OC 钻孔前）；51.46 ± 2.45°（OC 切除 1/3）；57.52 ± 2.66°（OC 切除 1/2）；这些值有显著差异（p<0.01）。JT 切除后岩斜区显露明显增加（p<0.01），而 OC 和 JT 部分切除后手术自由度明显增加（p<0.05）。我们得出结论，在远外侧锁孔入路中，OC 的部分钻孔可增加 LVFA；颈静脉结节钻孔后可进一步显露中斜坡；OC 和 JT 部分切除后手术自由度显著改善。
