CAJ | 학술논문

目的探讨颞骨岩部前后界和中脑前后界在体表和颅骨表面的投影,以确定在颞下经岩嵴入路骨瓣成形时,幕上颞枕部颅骨钻孔的位置. 方法 10例(20侧)国人汉族成人头部湿标本固定后在CT上以OM为基线对颅底行薄层扫描,并用钛钉定位标记相关解剖体表投影点.投影点钻孔(孔1位于耳屏前颧弓根部上缘的凹陷处,孔2位于顶乳缝前端上方l cm处;孔 3位于星点上方1 cm处),置入塑料管,测量相关数据. 结果 3个孔均位于幕上,对应颞叶底部.孔1在大脑表面大多数对应颞下回,在深面对应颞骨岩部前界和中脑前界;孔 2位于幕上,在深面对应颞骨岩部后界和中脑后界;孔 3对应小脑幕上缘和枕前切迹. 结论 3个孔的连线定位了小脑幕上缘的体表投影,可作为颞下经岩嵴入路开颅钻孔的定位点.
목적 탐토섭골암부전후계화중뇌전후계재체표화로골표면적투영,이학정재섭하경암척입로골판성형시,막상섭침부로골찬공적위치. 방법 10례(20측)국인한족성인두부습표본고정후재CT상이OM위기선대로저행박층소묘,병용태정정위표기상관해부체표투영점.투영점찬공(공1위우이병전권궁근부상연적요함처,공2위우정유봉전단상방l cm처;공 3위우성점상방1 cm처),치입소료관,측량상관수거. 결과 3개공균위우막상,대응섭협저부.공1재대뇌표면대다수대응섭하회,재심면대응섭골암부전계화중뇌전계;공 2위우막상,재심면대응섭골암부후계화중뇌후계;공 3대응소뇌막상연화침전절적. 결론 3개공적련선정위료소뇌막상연적체표투영,가작위섭하경암척입로개로찬공적정위점.
Objective To establish standard sites for bur holes that maintain constant anatomical relationships with the skull base and neural structures and can serve as the basal aspect of supratentorial temporooceipital craniotomies such as subtemporal transpetrosalridge approach.Methods To determine cranial-cerebral relationships,the authors delimited 10 adult cadaveric skulls anteriorly and posteriorly the external projection of the petrous bone and the midbrain by CT and Titanium nail.Then bur holes in adult cadaveric skulls were created (kl,the first bur hole,located anterior to the auricle of the ear; k2,the second bur hole,whose base was located 1 cm above the interface of the parietomastoid and squamous sutures; k3,the third bur hole whose base was located 1cm above the asterion).Three bur holes were made on each of the skulls (20 cerebral hemispheres).The author then introduced plastic catheters through the bur holes to evaluate pertinent cranial and neural landmarks.Results The first bur hole appeared to have a particular anatomical relationship with the anterior aspect of the petrous portion of the temporal bone and the most anterior aspect of the midbrain.The second bur hole had a particular relationship with the posterior border of the petrous portion of the temporal bone and with the posterior aspect of the midbrain.The third bur hole was mostly supratentorial and particularly related to the preoccipital notch.Conclusions The middle fossa floor is located anterior to the site of the kl,and the superior surface of the tentorium is posterior to k2.Together with k3,these bur holes can be considered standards for temporooccipital craniotomies such as subtemporal transpetrosalridge approach.