CAJ | 학술논문

目的：分析内镜下经口入路颅颈交界区腹侧解剖并探讨齿状突切除的改良。方法：观察并测量36具干性颅底、5套寰枢椎标本的解剖标志及数据，应用神经内镜在10例经过防腐处理及乙醇浸泡的汉族成人尸头标本上进行颅颈交界区腹侧的解剖，通过模拟手术探讨内镜控制下保留部分寰椎前结节切除齿状突的可行性。结果：寰椎前结节高（9．8±0．7） mm，厚（8．1±0．6） mm；齿状突高（13．1±2．7） mm，厚（14．2±2．4） mm。尸头模拟手术，不进行软颚切开暴露，选用F12单腔导尿管将两端分别从双侧鼻腔进入与软颚根部缝扎，鼻腔外适度牵拉悬吊导尿管使之充分暴露咽后壁，内镜控制下9例顺利磨除寰椎前结节下1/2及齿状突基底部，完成帽状取出齿状突顶部。结论：内镜控制下经口切除齿状突具有视野好、创伤小等优点。
목적：분석내경하경구입로로경교계구복측해부병탐토치상돌절제적개량。방법：관찰병측량36구간성로저、5투환추추표본적해부표지급수거，응용신경내경재10례경과방부처리급을순침포적한족성인시두표본상진행로경교계구복측적해부，통과모의수술탐토내경공제하보류부분환추전결절절제치상돌적가행성。결과：환추전결절고（9．8±0．7） mm，후（8．1±0．6） mm；치상돌고（13．1±2．7） mm，후（14．2±2．4） mm。시두모의수술，불진행연악절개폭로，선용F12단강도뇨관장량단분별종쌍측비강진입여연악근부봉찰，비강외괄도견랍현조도뇨관사지충분폭로인후벽，내경공제하9례순리마제환추전결절하1/2급치상돌기저부，완성모상취출치상돌정부。결론：내경공제하경구절제치상돌구유시야호、창상소등우점。
Aim: To analyse endoscopic transoral ventral craniocervical junction anatomy and to investigate the im -provement of odontoid resection .Methods:A total of 36 cases of dry skull base , 5 atlantoaxial specimens were observed . Neuroendoscopic anatomy of ventral craniocervical junction region was carried out in 10 Han adult cadaver head specimens . Results:The height of the anterior tubercle of the atlas was (9.8 ±0.7) mm, and the thickness was (8.1 ±0.6) mm;the height of the odontoid was (13.1 ±2.7) mm, and the thickness was (14.2 ±2.4) mm.Cadaveric head simulated op-eration need no soft palate incision exposure .The ends of F12 single lumen catheter were respectively sutured with the root of the soft palate through the nasal cavity .The catheter was moderately suspended to completely expose the posterior pha-ryngeal wall .The 1/2 anterior tubercle and the odontoid base of the atlas were ground under neuroendoscopy and the top of the odontoid was taken out .Conclusion:The excision of the odontoid through endoscopic transoral approach has good vi -sion with small lesion .