CAJ | 학술논문

目的研究小脑脑桥角区的解剖结构,为三叉神经痛与面肌痉挛微血管减压手术提供解剖学依据.方法 16例成人头颅湿标本,采用乙状窦后入路,对小脑脑桥角区行显微解剖研究.结果 (1)上界为上项线中点下2 cm,下界为枕骨大孔上缘1 cm,内侧界距枕窦缘3 cm,外侧界为乳突基底内侧0.5 cm的骨窗中心恰与面听神经垂直对应,是微血管减压的最佳骨窗.(2)脑池段三叉神经与面听神经最宽距离平均为(11.19±0.12)mm.(3)岩静脉距离面听神经平均为(10.05±0.11)mm.结论该区手术骨窗中心位置可行最佳选择.利用岩静脉与面听神经的间隙行微血管减压术无需切断岩静脉.
목적 연구소뇌뇌교각구적해부결구,위삼차신경통여면기경련미혈관감압수술제공해부학의거.방법 16례성인두로습표본,채용을상두후입로,대소뇌뇌교각구행현미해부연구.결과 (1)상계위상항선중점하2 cm,하계위침골대공상연1 cm,내측계거침두연3 cm,외측계위유돌기저내측0.5 cm적골창중심흡여면은신경수직대응,시미혈관감압적최가골창.(2)뇌지단삼차신경여면은신경최관거리평균위(11.19±0.12)mm.(3)암정맥거리면은신경평균위(10.05±0.11)mm.결론 해구수술골창중심위치가행최가선택.이용암정맥여면은신경적간극행미혈관감압술무수절단암정맥.
Objective To study the anatomy relationship among the vessles, nerves and bone landmarks in the region of CPA and provide operation-related anatomy knowledge for microvascular decompression of trigeminal neuralgia and hemifacial spasm. Method 16 cadaver specimens were used. 32 sides of CPA region were dissected with retrosigmoid approach. The optimal bone window center for Ⅶ,Ⅷ cranial nerves was localized and the relationship of nerves and vessels were observed and measured. Results (1)The bone window was 2 cm under the midpoint of superior nuchal line superiorly, 1 cm above superior margin of foramen magnum inferiorly, 3 cm lateral to occipital sinus medially, 0.5 cm medial to mamillary process base laterally. The center of the bone window was properly above the Ⅶ,Ⅷ cranial nerves. (2)The widest distance between the Ⅶ,Ⅷ cranial nerves and trigeminal nerve was 10.20～12.18 mm, mean (11.19±0. 12)mm in the cistern. (3)The distance between Ⅶ,Ⅷ cranial nerve and petrosal vein is 9.10±11.22 mm, mean(10.05±0.11)mm,and this interspace can be used to perform microvascular decompression without cutting off petrosal vein. Conclusions The bone window for microvascular decompression in CPA can be optimized to a special location. The locations of trigeminal nerve and Ⅶ,Ⅷ cranial nerves are relatively constant. Therefore these nerves can be used as intraoperative landmarks. The microvascular decompression operations can be performed in the interspace between nerves and vessles without cutting off petrosal vein.