Long Jennifer, Roberts David J H, Pickering James D
Section of Pathology, Anatomy and Tumour Biology, Leeds Institute of Cancer and Pathology, Worsley Building, University of Leeds, Leeds, LS2 9JT, United Kingdom.
Clin Anat. 2014 Jan;27(1):20-4. doi: 10.1002/ca.22356. Epub 2013 Dec 7.
Neuroanatomy teaching at the University of Leeds includes the examination of isolated brains by students working in small groups. This requires the prosected brains to exhibit all 12 pairs of cranial nerves. Traditional methods of removing the brain from the skull involve elevating the frontal lobes and cutting each cranial nerve as the brain is reflected posteriorly. This can leave a substantial length of each nerve attached to the skull base rather than to the removed brain. We have found a posterior approach more successful. In this study, five adult heads were disarticulated at the level of the thyroid cartilage and placed, prone, in a head stand. A wedge of bone from the occipital region was removed before the cerebellum and brainstem were elevated to visualize the cranial nerves associated with the medulla oblongata, cerebellopontine angle and mesencephalic-pontine junction prior to cutting them as close to the skull as possible. Five brains were successfully removed from the skull, each having a full complement of cranial nerves of good length attached to them. This approach significantly increases the length and number of cranial nerves remaining attached to the brain, which supports student education. For integration into head and neck dissection courses, careful consideration will be required to ensure the necks are suitably dissected and to decide whether the cranial nerves are best left attached to the skull base or brain.
利兹大学的神经解剖学教学包括让学生以小组形式检查分离的大脑。这要求解剖后的大脑展示出全部12对颅神经。传统的从颅骨中取出大脑的方法包括抬起额叶，并在大脑向后翻转时切断每对颅神经。这可能会使每根神经的相当长一段附着在颅底，而不是与取出的大脑相连。我们发现后入路更为成功。在本研究中，将5个成人头部在甲状软骨水平处离断，俯卧放置在头架上。在抬高小脑和脑干以观察与延髓、脑桥小脑角和中脑 - 脑桥交界处相关的颅神经之前，先从枕部区域切除一块楔形骨，然后尽可能靠近颅骨切断这些颅神经。成功从颅骨中取出了5个大脑，每个大脑都附着有完整且长度良好的颅神经。这种方法显著增加了附着在大脑上的颅神经的长度和数量，有助于学生的学习。为了将其纳入头颈解剖课程，需要仔细考虑以确保颈部得到适当解剖，并决定颅神经最好是留在颅底还是与大脑相连。
