CAJ | 학술논문

目的：观察迷路后和乙状窦后径路后组颅神经内镜手术的相关解剖结构，为后组颅神经内镜手术提供解剖资料。方法：在8例16侧成人尸头上模拟实施迷路后和乙状窦后径路后组颅神经内镜手术，观察手术径路上各结构对手术的影响以及第9～12颅神经之间的解剖关系；去除顶骨、大脑以及部分小脑组织，暴露颈静脉孔、内耳门及其周围结构，测量颈静脉孔上缘距内耳门下缘垂直距离。结果：8例16侧标本均顺利完成迷路后径路模拟内镜手术；2例4侧在不损伤小脑情况下顺利完成乙状窦后径路模拟手术，小脑为内镜导入的主要障碍。镜下观舌咽和迷走神经之间间距相对较大，迷走神经和副神经发生部相距很近；舌下神经位于上述颅神经前、内、下方，形成5～8束较细神经纤维平行分布。颈静脉孔上缘距内耳门下缘垂直距离为（8．26±1．05）mm。结论：迷路后径路为后组颅神经内镜手术较理想径路，而单纯依靠乙状窦后“锁孔”入路实施内镜手术相当困难；内耳门是手术中可靠的定位标志。
목적：관찰미로후화을상두후경로후조로신경내경수술적상관해부결구，위후조로신경내경수술제공해부자료。방법：재8례16측성인시두상모의실시미로후화을상두후경로후조로신경내경수술，관찰수술경로상각결구대수술적영향이급제9～12로신경지간적해부관계；거제정골、대뇌이급부분소뇌조직，폭로경정맥공、내이문급기주위결구，측량경정맥공상연거내이문하연수직거리。결과：8례16측표본균순리완성미로후경로모의내경수술；2례4측재불손상소뇌정황하순리완성을상두후경로모의수술，소뇌위내경도입적주요장애。경하관설인화미주신경지간간거상대교대，미주신경화부신경발생부상거흔근；설하신경위우상술로신경전、내、하방，형성5～8속교세신경섬유평행분포。경정맥공상연거내이문하연수직거리위（8．26±1．05）mm。결론：미로후경로위후조로신경내경수술교이상경로，이단순의고을상두후“쇄공”입로실시내경수술상당곤난；내이문시수술중가고적정위표지。
Objective:To provide anatomic data of lower cranial nerves to avoid damnification in the endoscopic surgery.Methods:To perform the postlabyrinthine and postsigmoid endoscopic surgery on 8 fomalin-fixed adult cadaver specimens , the lower cranial nerves was observed by endoscope , and the different approa-ches were compared at the same time .To excise the calvarium and cereburm , the nerves were exposed and ob-served, the distance from internal accoustic pore to glossopharyngeal was measured .Results:All postlabyrin-thine endoscopic surgeries were performed successfully;only 4 postsigmoid endoscopic surgeries were performed as well.The distance from internal accoustic pore to glossopharyngeal was (8.26 ±1.05)mm.Conclusions:The lower cranial nerves endoscopic surgery can be performed successfully by postlabyrinthine , the“lockhole” tech-nology by postsigmoid is not the appropriate lower cranial nerves endoscopic surgery .The internal acoustic porus is a fixed structure of the cerebellopontine angle;it is a perfect landmark to the surgery .