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目的利用改良额颞颧弓(FTZ)开颅,结合深部骨质切除对Willis环及其主要分支显露进行显微解剖学研究。方法利用10例尸头标本行10侧FTZ开颅,借助显微磨钻,在手术显微镜下切除前、后床突及部分岩骨等,用于显露Willis环及其主要分支,尤其基底动脉、对侧颈内动脉床突上段、大脑中动脉水平段(M1);同时行10侧标准翼点入路暴露上述结构。结果改良FTZ入路较常规翼点入路可更好暴露Willis环及其主要分支。结论改良FTZ入路可用于处理Willis环及其主要分支的多发动脉瘤,并且是较好的选择。
Objective To investigate the microsurgical anatomy of the Willis ring and its major branches by means of a modified frontotemporal zygomatic arch (FTZ) craniotomy combined with deep osteotomy. Methods 10 cases of cadaver heads were performed with 10 sides of FTZ craniotomy. Microsurgical drilling was used to excise the Willis ring and its major branches, especially basilar artery, On the contralateral internal carotid artery superior mesenteric segment, the middle cerebral artery horizontal segment (M1); while 10 sides of the standard pterional approach exposed the above structure. Results The improved FTZ approach exposed the Willis ring and its major branches better than the conventional pterional approach. Conclusion The modified FTZ approach can be used to treat the multiple aneurysms of the Willis ring and its major branches, and is a better choice.