CAJ | 학술논문

目的观察小脑延髓裂入路沿途组织结构间的毗邻关系,为临床提供解剖学基础.方法将经甲醛固定、血管内灌注彩色乳胶的5例成人尸头标本,按手术入路逐层解剖.观察小脑延髓裂的组成,以及脉络膜、下髓帆、小脑下后动脉的走形及分布.结果小脑延髓裂是位于扁桃体、二腹叶下方与延髓之间行向外侧的一条自然解剖裂隙.脉络膜、下髓帆不含神经组织,分离该组织,可暴露整个第四脑室.小脑下后动脉的扁桃体延髓段和膜髓帆扁桃体段是此入路的关键血管.结论小脑延髓裂入路可以不切开下蚓部,通过正常的解剖间隙到达第四脑室和脑干的侧方,可减少手术的损伤及术后并发症.
목적 관찰소뇌연수렬입로연도조직결구간적비린관계,위림상제공해부학기출.방법 장경갑철고정、혈관내관주채색유효적5례성인시두표본,안수술입로축층해부.관찰소뇌연수렬적조성,이급맥락막、하수범、소뇌하후동맥적주형급분포.결과 소뇌연수렬시위우편도체、이복협하방여연수지간행향외측적일조자연해부렬극.맥락막、하수범불함신경조직,분리해조직,가폭로정개제사뇌실.소뇌하후동맥적편도체연수단화막수범편도체단시차입로적관건혈관.결론 소뇌연수렬입로가이불절개하인부,통과정상적해부간극도체제사뇌실화뇌간적측방,가감소수술적손상급술후병발증.
Objective To study transcerebellomedullary fissure approach to the fourth ventricle and the lateral brainstem without splitting vermis and depict its adjacent structure, and provide clinicians with anatomical information.Methods Five cadaveric heads fixed with formaldehyde and perfused with color latex in their arteries and veins were dissected with microsurgical anatomical skills. The composition of cerebellomedullary fissure and the distribution of the tela choroida, the inferior medullary velum and the posterior inferior cerebellar artery, and study anatomic base of this approach.Results Cerebellomedullary fissure is a natural anatomical gap which is located between the cerebellar tonsil, biventral lobule and medulla oblongata. The tela choroida and inferior medullary velum do not contain nerve tissue, and thus can be dissected to expose the fourth ventricle. The tonsil- medulla segment and telovelotonsillar segment of the posterior inferior cerebellar artery are the most important blood vessels of the cerebellomedullary fissure approach.Conclusions The transcerebellomedullary fissure approach can reach the fourth ventricle and dorsal brain stem through normal anatomic spaces without splitting the vermis, thus reducing the post-operative complications.