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颈静脉孔脑膜构筑:应用塑化切片的解剖学研究。

Meningeal Architecture of the Jugular Foramen: An Anatomic Study Using Plastinated Histologic Sections.

机构信息

Department of Anatomy, Anhui Medical University, Hefei, China; Chinese Brain Bank, Anhui Medical University, Hefei, China.

Department of Anatomy, Anhui Medical University, Hefei, China.

出版信息

World Neurosurg. 2019 Jul;127:e809-e817. doi: 10.1016/j.wneu.2019.03.272. Epub 2019 Apr 5.

Abstract

OBJECTIVE

This 3-dimensional histologic study aimed to provide a precise description of the meningeal structures in the jugular foramen.

METHODS

22 posterior skull base tissue blocks containing the jugular foramen region were obtained from 11 human cadaveric heads. These blocks were plastinated and cut into serial sections. After staining, these sections were examined under an optical microscope and used to reconstruct a 3-dimensional visualization model.

RESULTS

At the intracranial orifice of the jugular foramen, the meningeal dura formed 2 separate dural perforations: the glossopharyngeal meatus and the vagal meatus. The arachnoid extended into 2 dural meatuses and terminated at the inferior ganglion of the glossopharyngeal nerve in the glossopharyngeal meatus and the superior ganglion of the vagus nerve in the vagal meatus. At the intraforaminal part of the jugular foramen, the meningeal dura encased the glossopharyngeal nerve to form a dural sheath while encasing the vagus and accessory nerves to form a dural network. At the extracranial orifice of the jugular foramen, the dural wall of the jugular bulb extended downward to form a dense connective tissue sheath. The initial end of the internal jugular vein invaginated into this sheath and fused with the jugular bulb.

CONCLUSIONS

Knowledge of the anatomy of the meningeal architecture of the jugular foramen can be helpful in avoiding surgical complications of the lower cranial nerves when this complex area is approached.

摘要

目的

本三维组织学研究旨在精确描述颈静脉孔内的脑膜结构。

方法

从 11 个人体头颅标本中获取包含颈静脉孔区域的 22 个后颅底组织块。这些组织块被塑化并切成连续切片。染色后,在光学显微镜下检查这些切片,并用于重建三维可视化模型。

结果

在颈静脉孔的颅内口,脑膜硬脑膜形成了 2 个单独的硬脑膜穿孔:舌咽神经管和迷走神经管。蛛网膜延伸到 2 个硬脑膜管中,在舌咽神经管中终止于舌咽神经的下神经节,在迷走神经管中终止于迷走神经的上神经节。在颈静脉孔的孔内部分,脑膜硬脑膜包裹舌咽神经形成硬脑膜鞘,同时包裹迷走神经和副神经形成硬脑膜网络。在颈静脉孔的颅外口,颈静脉球的硬脑膜壁向下延伸形成致密的结缔组织鞘。颈内静脉的起始端向内凹陷到这个鞘中,并与颈静脉球融合。

结论

了解颈静脉孔脑膜结构的解剖结构有助于避免在接近这个复杂区域时发生颅神经的手术并发症。

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