Department of Neurosurgery, Catholic University of Korea, Seoul, South Korea.
Clin Anat. 2012 Nov;25(8):1030-42. doi: 10.1002/ca.22047. Epub 2012 Feb 14.
The aim of this study is to demonstrate and review the detailed microsurgical anatomy of the abducens nerve and surrounding structures along its entire course and to provide its topographic measurements. Ten cadaveric heads were examined using ×3 to ×40 magnification after the arteries and veins were injected with colored silicone. Both sides of each cadaveric head were dissected using different skull base approaches to demonstrate the entire course of the abducens nerve from the pontomedullary sulcus to the lateral rectus muscle. The anatomy of the petroclival area and the cavernous sinus through which the abducens nerve passes are complex due to the high density of critically important neural and vascular structures. The abducens nerve has angulations and fixation points along its course that put the nerve at risk in many clinical situations. From a surgical viewpoint, the petrous tubercle of the petrous apex is an intraoperative landmark to avoid damage to the abducens nerve. The abducens nerve is quite different from the other nerves. No other cranial nerve has a long intradural path with angulations and fixations such as the abducens nerve in petroclival venous confluence. A precise knowledge of the relationship between the abducens nerve and surrounding structures has allowed neurosurgeon to approach the clivus, petroclival area, cavernous sinus, and superior orbital fissure without surgical complications.
本研究旨在展示和回顾展神经及其周围结构的详细显微解剖，沿着其整个过程，并提供其地形测量。在将动脉和静脉注入彩色硅树脂后，使用×3 至×40 倍放大倍数检查了 10 个尸体头颅。使用不同的颅底入路对每个尸体头颅的两侧进行解剖，以展示展神经从桥延沟到外直肌的整个过程。由于存在高密度的重要神经和血管结构，岩斜区和海绵窦中展神经通过的解剖结构非常复杂。展神经在其行程中有弯曲和固定点，这使得神经在许多临床情况下处于危险之中。从手术的角度来看，岩锥的岩锥结节是避免损伤展神经的术中标志。展神经与其他神经非常不同。没有其他颅神经像岩斜静脉汇合处的展神经那样具有长的、有弯曲和固定的颅内路径。对展神经与周围结构之间关系的准确了解使神经外科医生能够在不发生手术并发症的情况下接近斜坡、岩斜区、海绵窦和眶上裂。
