Matsuo Satoshi, Komune Noritaka, Kurogi Ryota, Akagi Yojiro, Iihara Koji
Department of Neurosurgery, National Hospital Organization, Kyushu Medical Center, Fukuoka, Japan.
Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
World Neurosurg. 2018 Jun;114:e597-e604. doi: 10.1016/j.wneu.2018.03.038. Epub 2018 Mar 14.
This study aims to determine whether the line between the digastric point and posterior edge of the occipital condyle (DC line) could be a new surface landmark for the posterior margin of the horizontal part of the sigmoid sinus.
Cadaveric specimens were used to show the relationship between the DC line and retrosigmoid craniotomy. Three-dimensional computed tomography angiography images of adult heads (56 sides) were analyzed to measure the distance between the DC line and the horizontal part of the sigmoid sinus at the digastric point, posterior edge of the condyle, and midpoint of the line.
The DC line was roughly parallel and posterior to the posterior margin of the sigmoid sinus. The distance between the DC line and the posterior edge of the sigmoid sinus at the digastric point, condyle, and midpoint of the line measured 4.7 ± 3.3 mm, 5.9 ± 2.6 mm, and 1.3 ± 2.2 mm, respectively. All sigmoid sinuses coursed anterior to the digastric point and condyle but in 17.9% (10/56 sides) the posterior edge of the sigmoid sinus extended a maximum of 4.1 mm posterior to the midpoint of the DC line.
The DC line can be used as a new surface landmark for estimating the position of the horizontal part of the sigmoid sinus. The posterior edge of the sinus may extend posterior to the line at the midpoint; thus, care should be taken to prevent sinus injury when drilling around the midpoint of the line.
本研究旨在确定二腹肌点与枕髁后缘之间的连线（DC线）是否可作为乙状窦水平部后缘的新的体表标志。
使用尸体标本展示DC线与乙状窦后入路开颅术之间的关系。分析56侧成人头部的三维计算机断层血管造影图像，测量DC线在二腹肌点、髁后缘及连线中点处与乙状窦水平部之间的距离。
DC线大致与乙状窦后缘平行且位于其后。DC线在二腹肌点、髁及连线中点处与乙状窦后缘之间的距离分别为4.7±3.3mm、5.9±2.6mm和1.3±2.2mm。所有乙状窦均走行于二腹肌点和髁的前方，但在17.9%（10/56侧）的标本中，乙状窦后缘在DC线中点后方最多延伸4.1mm。
DC线可作为估计乙状窦水平部位置的新的体表标志。窦的后缘在连线中点处可能延伸至线的后方；因此，在该线中点周围钻孔时应注意防止窦损伤。
