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目的:了解海绵窦(cavernoussinus,CS)有关的三角的显微解剖,为CS病变直接手术提供安全手术入路。方法:20例成人头部标本,在显微镜下对CS颅内三壁有关三角进行解剖观察和测量。结果:CS上壁内有前内侧三角和内侧三角;外壁内及其附近有旁内侧三角、Parkinson三角、Mulan三角、外侧三角、Glascock三角和Kawase三角;后壁上有下外侧三角和下内侧三角。在总共10个三角中,上壁的内侧三角和外壁的Parkinson三角能暴露的CS结构最多。此二者结合起来几乎能显露CS的所有部位和结构。结论:CS三角为其病变直接手术提供既不损伤重要神经血管又能进入CS内的安全手术入路。其中最常用的是内侧三角和Parkinson三角。临床上最常应用的额颞骨瓣(翼点入路)CS上壁和外壁联合入路就是经该2个三角进入CS的。
Objective: To understand the cavernous sinus (cavernoussinus, CS) related to the triangular microanatomy, CS surgery for direct surgical approach to provide a safe operation. Methods: Twenty adult head specimens were dissected and observed under a microscope. Results: There were anterior medial trigone and medial trigone in the upper wall of CS. There were lateral medial trigonometry, Parkinson trigonometry, Mulan triangulation, lateral trigonometry, Glascock trigonometry and Kawase triangulation in and around the epicardium. There were inferior lateral trigone and inferior medial trigone in the posterior wall . Of a total of 10 triangles, the Parkinson triangles of the medial trigone of the superior wall and the outer wall can expose the most CS structures. The combination of the two reveals almost all parts and structures of CS. CONCLUSIONS: The CS triangle provides a safe surgical approach to direct lesion surgery that does not compromise vital neurovascular as well as CS. The most commonly used ones are the medial triangle and the Parkinson triangle. The most commonly used clinical application of the frontotemporal flap (pterional approach) CS upper wall and outer wall of the joint approach is through the two triangles into the CS.