Fam Maged D, Potash Andrea, Potash Martin, Robinson Robert, Karnell Lucy, O'Brien Erin, Greenlee Jeremy D W
Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, United States.
Department of Otolaryngology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, United States.
J Neurol Surg B Skull Base. 2018 Dec;79(6):614-620. doi: 10.1055/s-0038-1651501. Epub 2018 Jun 5.
Dural membrane is an important anatomic structure that surrounds and protects the entire central nervous system. Physical properties of the dura have many pathophysiological and therapeutic implications in cranial surgery, especially skull base disorders. The aim of this study is to investigate variation in skull base dural thickness and correlation with different demographic parameters. At the time of autopsy, the petrous apex dura with the underlying bone of 20 cadavers was harvested. Dural thickness was independently measured by two pathologists at the thinnest and thickest segments in the specimen. Correlational analyses were then performed to compare dural thickness with gender, age, neck circumference, height, weight, and body mass index (BMI). Mean, minimum, and maximum skull base dural thickness in our study was 0.36, 0.27, and 0.46 mm, respectively. Age demonstrated a negative correlation with dural thickness with significantly thinner dura in the older subjects, = 0.01. There was a trend toward thinner dura in females that approached statistical significance, = 0.06. No strong correlation could be found with body weight, height, neck circumference, or BMI. Our findings show a considerable intersubject and intrasubject variability in skull base dural thickness. Some demographic parameters also seem to impact dural thickness. Additional histological studies are needed for better understanding of the pathophysiological mechanisms pertaining to the tensile properties of the dural membrane.
硬脑膜是围绕并保护整个中枢神经系统的重要解剖结构。硬脑膜的物理特性在颅脑手术尤其是颅底疾病中具有许多病理生理和治疗意义。本研究的目的是调查颅底硬脑膜厚度的变化及其与不同人口统计学参数的相关性。在尸检时,采集了20具尸体的岩尖硬脑膜及其下方的骨质。由两名病理学家独立测量标本中最薄和最厚部位的硬脑膜厚度。然后进行相关性分析,以比较硬脑膜厚度与性别、年龄、颈围、身高、体重和体重指数(BMI)。在我们的研究中,颅底硬脑膜的平均、最小和最大厚度分别为0.36、0.27和0.46毫米。年龄与硬脑膜厚度呈负相关,老年受试者的硬脑膜明显更薄,P = 0.01。女性硬脑膜有变薄的趋势,接近统计学意义,P = 0.06。未发现与体重、身高、颈围或BMI有强相关性。我们的研究结果表明,颅底硬脑膜厚度在个体间和个体内存在相当大的变异性。一些人口统计学参数似乎也会影响硬脑膜厚度。需要进行更多的组织学研究,以更好地理解与硬脑膜拉伸特性相关的病理生理机制。