论文部分内容阅读
作者们描述了广泛暴露颅底的新手术方法:气管切开后气管内麻醉,切口从下唇中央向下延伸到舌骨平面,向外成直角达胸锁乳突肌后,再弯曲向上至乳突尖;分离翻转皮瓣,保护下颌缘神经,在舌骨附着处切断二腹肌和茎突舌骨肌,连同颌下腺向上牵开;辨认颈动脉、颈内静脉和Ⅹ、Ⅺ、Ⅻ脑神经,并将其保护在切口中。中线切开下颌骨骨膜并向外分离2cm,在下颌骨中线用Gigli锯将其作阶梯形锯开,于阶梯形的垂直切缘两侧分别钻孔以备用金属线缝合。从Wharton氏管孔间切开口底粘膜向后延伸至扁桃体前柱,分离颌下腺,向外侧牵开下颌,暴露咽旁隙。然后在面动脉水平行颈外动脉钝性分离。于茎突尖处分离茎突舌骨韧带、茎突舌骨肌和茎突
The authors describe a new surgical approach to extensive exposure of the skull base: endotracheal anesthesia after tracheotomy, incision extending from the center of the lower lip to the hyoid plane, outward at a right angle to the sternocleidomastoid, and then bending upward Mastoid tip; separated flip flap to protect the mandibular margin of the nerve, cut off in the hyoid attachment of the abdominal muscles and stylohyoid muscle, together with the submandibular gland upward retraction; identify the carotid artery, internal jugular vein and Ⅹ, Ⅺ, Ⅻ brain Nerve, and protect it in the incision. The midline mandibular periosteum incision and outward separation 2cm, in the mandibular midline with a Gigli saw to step saw it open, on both sides of the vertical cut edge of the vertical drilling to spare suture. From Wharton’s tube, the mucosa of the mucosa was cut back to the anterior tonsillar, the submandibular gland was dissected, the mandible was retracted to expose the parapharyngeal space. Then blunt dissection of the external carotid artery in the level of facial artery. The styloid process in the apical styloid ligament separation, stylohyoid muscle and styloid process