Manduca Palmiero Helbert de Oliveira, Silva da Costa Marcos Devanir, Caramanti Ricardo Lourenço, Eduardo Aparecido Chaddad-Neto Feres
a Neurocirurgia , Universidade Federal de Sao Paulo Escola Paulista de Medicina , Sao Paulo , Brazil.
b Departamento de Neurocirurgia, Universidade Federal de Sa Paulo Escola Paulista de Medicina , Sao Paulo , Brazil.
Br J Neurosurg. 2018 Jun;32(3):250-254. doi: 10.1080/02688697.2018.1426722. Epub 2018 Jan 15.
The cerebellopontine angle (CPA) is a subarachnoid space in the lateral aspect of the posterior fossa. In this study, we propose a complementary analysis of the CPA from the cerebellopontine fissure.
We studied 50 hemi-cerebelli in the laboratory of neuroanatomy and included a description of the CPA anatomy from the cerebellopontine fissure and its relationship with the flocculus and the 5th, 6th, 7th, and 8th cranial nerves (CN) origins.
The average distance from the 5th CN to the mid-line (ML) was 19.2 mm, 6th CN to ML was 4.4 mm, 7-8 complex to ML was 15.8 mm, flocculus to ML was 20.5 mm, and flocculus to 5th CN was 11.5 mm, additionally, and the diameter of the flocculus was 9.0 mm. The angle between the vertex in the flocculus and the V CN and the medullary-pontine line was 64.8 degrees.
The most common access to the CPA is through the retrosigmoid-suboccipital region and this approach can be done with the help of an endoscope. The anatomy of origins of neural structures tends to be preserved in cases of CPA lesions.
Knowledge of the average distances between the neural structures in the cerebellar-pontine fissure and the angular relationships between these structures facilitates the use of surgical approaches such as microsurgery and endoscopy.
桥小脑角(CPA)是后颅窝外侧的一个蛛网膜下腔。在本研究中,我们提出从桥小脑裂对CPA进行补充分析。
我们在神经解剖实验室研究了50个半小脑,并描述了从桥小脑裂观察到的CPA解剖结构及其与绒球以及第5、6、7和8对脑神经(CN)起始部的关系。
第5对脑神经到中线(ML)的平均距离为19.2毫米,第6对脑神经到ML为4.4毫米,第7 - 8神经复合体到ML为15.8毫米,绒球到ML为20.5毫米,绒球到第5对脑神经为11.5毫米,此外,绒球直径为9.0毫米。绒球顶点与第5对脑神经以及延髓 - 脑桥线之间的夹角为64.8度。
进入CPA最常用的途径是通过乙状窦后 - 枕下区域,并且这种方法可以在内窥镜辅助下进行。在CPA病变的情况下,神经结构的起始部解剖往往得以保留。
了解桥小脑裂中神经结构之间的平均距离以及这些结构之间的角度关系有助于使用诸如显微手术和内窥镜检查等手术方法。