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目的对上颈椎前路咽后入路进行解剖学研究,为应用内镜行上颈椎前路手术提供解剖学依据。方法对10具防腐和3具新鲜成人尸体标本进行C臂机下模拟上颈椎前路手术内固定及逐层解剖,测量咽后壁厚度,观察穿刺套管经甲状腺上动脉下方入路时与重要血管神经等结构的相应关系,分析MED下进行上颈椎前路咽后壁手术的安全性。结果MED套管与甲状腺上血管、神经相邻,而距离舌下神经、舌动脉、舌咽神经等较远。在颈1～2水平咽后壁正中旁开10 mm软组织厚度平均为(5.32±2.14)mm,咽后间隙与椎前间隙之间可以形成较大腔隙,足可以安全放置外径18 mm套管。结论经内镜下行上颈椎前路咽后手术入路是安全的。
Objective To study the anatomy of anterior cervical anterior pharyngeal approach to provide anatomic evidence for anterior cervical spine surgery. Methods Ten anticorrosive and three fresh adult cadaver specimens were subjected to C-arm anterior cervical spine anterior internal fixation and layer-by-layer anatomy. The posterior pharyngeal wall thickness was measured. The puncture cannula under the superior thyroid artery Vascular nerves and other structures of the corresponding relationship between the analysis of MED underwent anterior cervical anterior pharyngeal wall surgery safety. Results MED sheath and thyroid on the blood vessels, nerves adjacent to, and from the hypoglossal nerve, lingual artery, glossopharyngeal nerve and other farther. The average thickness of 10 mm soft tissue adjacent to the middle of the posterior pharyngeal wall at the level of 1 to 2 of the neck was (5.32 ± 2.14) mm, a large lacuna was formed between the posterior pharyngeal space and the anterior vertebral space, tube. Conclusions It is safe to endoscopic anterior thoracoscopic surgery via endoscopic approach.