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目的研究颞下经小脑幕锁孔入路对岩斜-后海绵窦区结构的显微解剖,为临床应用该入路解决该区病变提供解剖学依据,同时探讨它在处理岩斜-后海绵窦区病变时的局限性。方法应用福尔马林固定的成人湿性头颅标本10例20侧,模拟颞下经小脑幕锁孔入路对岩斜-后海绵窦区进行显微解剖观察。结果颞下经小脑幕锁孔入路可以清楚暴露小脑幕上中颅底及后海绵窦结构,切开小脑幕后可以暴露动眼神经、滑车神经、三叉神经、环池、后交通动脉、基底动脉顶部、大脑后动脉、中脑的前外侧部等结构。但由于岩骨嵴的阻挡,无法观察岩骨后颅窝面。结论颞下经小脑幕锁孔入路完全能达到传统颞底大骨瓣开颅对岩斜-后海绵窦区的暴露范围,同时具有创伤小、易于操作的优点,但处理基底位于岩骨后颅窝面的大型岩斜区肿瘤存在一定的局限性。
Objective To study the microsurgical anatomy of the petroclival-posterior cavernous sinus region through the inferior temporal and interocular keyhole approach and to provide an anatomical basis for the clinical application of this approach in the treatment of the lesion in this region. Meanwhile, Sinus lesions when the limitations. Methods 10 cases of formalin-fixed adult wet skull specimens were used to simulate the anatomic observation of petroclival-posterior cavernous sinus by simulating the infratentorial incision of the inferior cerebellar tentorium. Results Temporomandibular closure keyhole approach can clearly expose the skull base and posterior cavernous sinus structure in the supratentorial tentorium, and expose the oculomotor nerve, trochlear nerve, trigeminal nerve, cistern, posterior communicating artery, basilar artery The top, the posterior cerebral artery, the anterior portion of the midbrain and other structures. However, due to the blocking of rock ridge, can not observe the bone surface of the cranial fossa. Conclusions Temporomandibular closure keyhole approach can completely reach the range of exposure to the petroclival-posterior cavernous sinus with the traditional large temporal craniotomy, and has the advantages of less trauma and easier operation. However, Large craniofacial petroclival area tumor there are some limitations.