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目的研究枕下远外侧入路、耳后乙状窦前经颞入路、改良的耳后头颈入路对颈静脉孔区显露范围与结构的区别。方法用10%的福尔马林固定的成人头颈湿标本6具(12侧),随机分为A、B、C三组,每组2具标本,在高倍显微镜下模拟颈静脉孔区手术入路。其中A组模拟枕下远外侧入路、B组模拟耳后乙状窦前经颞入路、C组模拟改良的耳后头颈入路进行显微解剖研究,比较各条手术入路所显露的结构及范围。结果枕下远外侧入路对颈静脉孔区颅内结构显露良好;耳后乙状窦前经颞入路对颈静脉孔孔内结构、鼓室、乳突气房及颈动脉鞘周围的结构显露良好;改良的耳后头颈入路则通过后、外、上、下等多个角度对颅内外结构均显露良好。结论不同的手术入路对颈静脉孔区的显露范围及结构各不相同,改良的耳后头颈入路能够更好的从多角度对颅内外结构显露,从而达到一期全切肿瘤。
Objective To study the difference between the suboccipital distal approach, the posterior sigmoid sinus via the temporal approach, and the modified posterior head and neck approach to reveal the extent and structure of the jugular foramen region. Methods Six adult (10 sides) formalin-fixed wethead and head specimens were divided into three groups (A, B and C) randomly, and each group consisted of two specimens. Under high power microscope, the jugular foramen road. A group of simulated suboccipital distal approach, B group simulate the posterior sigmoid sinus by the temporal approach, C group simulated modified head and neck approach microsurgical anatomy study, compared with the various surgical approaches revealed Structure and scope. Results The suboccipital distal approach showed a good visualization of the intracranial structures in the jugular foramen region. The structures of the jugular foramen, the tympanic cavity and the carotid sheath around the posterior sigmoid sinus were revealed by the temporal approach Good; improved head and neck through the back of the neck through the way, outside, up, down and other angles on the structure of both intracranial revealed good. Conclusions Different surgical approaches have different range and structure of perforation of jugular foramen region. The improved posterior head and neck approach can reveal the intracranial and extracranial structures better from multiple perspectives, so as to achieve a complete resection of the tumor.