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目的为内镜下远外侧枕髁后锁孔入路治疗岩下斜区及周围疾患提供解剖学基础。方法 10具尸体头标本于乳突后作纵向“S”型、约7 cm长头皮切口,上缘起自乳突中点向后2 cm处,下界至C2水平。做直径约2 cm的骨窗,牵开小脑半球,内镜下观察所显露的解剖结构。结果内镜下可以观察到后组脑神经的出颅部位,包括颈静脉孔和舌下神经管内口,此外,还可以显露脑干腹侧面的结构及椎动脉的末端。神经与血管间复杂毗邻关系亦可得以显示;骨窗外缘至颈静脉内口的距离为(1.75±0.29)cm。结论内镜的使用,可缩小远外侧枕髁后锁孔入路的骨窗;副神经的脊髓根及颈静脉孔内口均可以作为经远外侧枕髁后锁孔入路内镜下岩下斜区结构的定位标识。
Objective To provide an anatomical basis for the treatment of oblique and peripheral disorders in the rock by endoscopic locking of the lateral occipital condyle. Method 10 specimens of the head of the cadaver after mastoid longitudinal “S ” type, about 7 cm long scalp incision, the upper margin from the middle of the mastoid backward 2 cm, the lower bound to the C2 level. Do the bone window about 2 cm in diameter, retract the cerebellar hemispheres, endoscopic observation revealed the anatomy. Results The posterior cranial nerves of cranial nerves in the posterior group were observed under endoscopy, including the jugular foramen and the inner mouth of the hypoglossal canal. In addition, the ventral aspect of the brainstem and the tip of the vertebral artery could also be revealed. The complex adjacent relationship between nerves and blood vessels can also be displayed; the distance from the outer edge of the bone window to the mouth of the jugular vein is (1.75 ± 0.29) cm. Conclusion The use of endoscopy can narrow the posterior occiput posterior keyhole approach the bone window; spinal cord root and jugular foramen of the accessory nerve can be used as the distal lateral occiput condyle posterior keyhole approach endoscopic oblique rock District structure of the logo.