CAJ | 학술논문

目的对岩上静脉的引流类型进行解剖分类,探讨其在颞下经小脑幕入路和乙状窦后经内听道上嵴入路中对手术暴露空间的影响.方法解剖10个国人成人尸头,共20侧,观察后颅窝、颞骨岩部重要结构的形态,测量岩上静脉及附近的重要结构之间的距离,根据沿岩骨嵴的岩上静脉注入岩上窦处与Meckel腔(MC)、内耳道(IAM)的关系确定岩上静脉的引流类型.另外用2个完整尸头,分别探讨岩上静脉的引流类型对颞下经小脑幕入路、乙状窦后经内听道上嵴入路的影响和与之相关解剖结构的关系.结果岩上静脉起源于小脑脑桥角池,其属支较多.根据岩上静脉汇入岩上窦的入口处与MC和IAM的关系将岩上静脉的引流类型分为三型.Ⅰ型:入口在MC的上方或内侧.Ⅱ型:入口在面神经入IAM处内侧和三叉神经入MC处外侧之间.Ⅲ型:入口在IAM的上方或外侧.结论岩上静脉注入岩上窦的位置与MC和IAM关系密切,根据其与MC和IAM的位置关系将岩上静脉的引流类型分为Ⅰ、Ⅱ、Ⅲ型,且对颞下经小脑幕入路和乙状窦后经内听道上嵴入路具临床指导意义,对沿着岩骨尖计划手术入路和减少术中岩上静脉损伤有临床意义.
목적 대암상정맥적인류류형진행해부분류,탐토기재섭하경소뇌막입로화을상두후경내은도상척입로중대수술폭로공간적영향.방법 해부10개국인성인시두,공20측,관찰후로와、섭골암부중요결구적형태,측량암상정맥급부근적중요결구지간적거리,근거연암골척적암상정맥주입암상두처여Meckel강(MC)、내이도(IAM)적관계학정암상정맥적인류류형.령외용2개완정시두,분별탐토암상정맥적인류류형대섭하경소뇌막입로、을상두후경내은도상척입로적영향화여지상관해부결구적관계.결과 암상정맥기원우소뇌뇌교각지,기속지교다.근거암상정맥회입암상두적입구처여MC화IAM적관계장암상정맥적인류류형분위삼형.Ⅰ형:입구재MC적상방혹내측.Ⅱ형:입구재면신경입IAM처내측화삼차신경입MC처외측지간.Ⅲ형:입구재IAM적상방혹외측.결론 암상정맥주입암상두적위치여MC화IAM관계밀절,근거기여MC화IAM적위치관계장암상정맥적인류류형분위Ⅰ、Ⅱ、Ⅲ형,차대섭하경소뇌막입로화을상두후경내은도상척입로구림상지도의의,대연착암골첨계화수술입로화감소술중암상정맥손상유림상의의.
Objective The purpose of this study was to dissect these structure existed in petrous portions of the temporal bones and the posterior fossa nearby,to measure the distence of those important stuctures around the superior petrosal venous (SPV), to propose the patterns of drainage of the SPV along the petrous ridge in relation to the Meckel cave and internal acoustic meatus (IAM) and to delineate its effect on the surgical exposures obtained in subtemporal transtentorial and retrosigmoid suprameatal approaches. Methods Ten adult cadaveric heads (20 hemispheres) were studied, and data of SPV and the structures around were measured. The patterns of drainage of the SPV along the petrous ridge were characterized according to their relation to the Meckel cave and the IAM based on an examination of 20 hemispheres. Subtemporal trans-tentorial and retrosigmoid suprameatal approaches were performed in two additional cadavers to demonstrate the effect of the drainage pattern on the surgical exposures. Result The SPV originated from the cerebellopontine angle cistern, and were multibranch. According to SPV relationship with the Meckel cave and internal acoustic meatus (IAM), the patterns of drainage of the SPV were classified into three groups. Type Ⅰ emptied into the SPS above or medial to the Meckel cave. The most common type-Type Ⅱ, emptied between the lateral limit of the trigeminal nerve at the Meckel cave and the medial limit of the facial nerve at the IAM. Type Ⅲ emptied into the SPS above and lateral to the boundaries of the IAM Conclusions The site which the SPV emptied into the superior petrosal sinus (SPS) was relationship tightly with the Meckel cave and IAM. According to SPV relationship with the Meckel cave and internal acoustic meatus (IAM). The proposed modified classification system and its effect on the surgical exposure may aid in planning the approach directed along the petrous apex and may reduce the probability of venous complications.