Norgren R, Smith G P
Department of Behavioral Science, College of Medicine, Pennsylvania State University, Hershey 17033.
Am J Physiol. 1994 Oct;267(4 Pt 2):R1136-41. doi: 10.1152/ajpregu.1994.267.4.R1136.
Although normally a mixed nerve, intracranially the vagus separates into dorsal rootlets that contain afferent axons and ventral rootlets that contain efferents. Surgical procedures are described for exposing the ventral surface of the occipital bone at the level where the vagus passes through the posterior lacerated foramen. When the foramen is expanded medially and the dura lanced, the intracranial course of the vagus can be observed by use of an operating microscope. Under these conditions, either the efferent or the afferent rootlets can be severed selectively. When the dorsal rootlets are divided and the contralateral trunk is cut below the diaphragm, a selective bilateral subdiaphragmatic afferent vagotomy is produced with unilateral sparing of the efferents. Cutting the efferents intracranially has the converse effect.
虽然迷走神经通常是混合神经,但在颅内它会分离成包含传入轴突的背根丝和包含传出轴突的腹根丝。本文描述了一些外科手术步骤,用于暴露枕骨腹侧面迷走神经穿过破裂孔后部的水平位置。当该孔向内侧扩大并切开硬脑膜时,可使用手术显微镜观察迷走神经的颅内走行。在这些条件下,可以选择性地切断传出或传入根丝。当切断背根丝并在横膈膜下方切断对侧迷走神经干时,就会产生选择性双侧膈下传入迷走神经切断术,而传出神经单侧保留。在颅内切断传出神经则会产生相反的效果。