中华神经医学杂志
中華神經醫學雜誌
중화신경의학잡지
CHINESE JOURNAL OF NEUROMEDICINE
2014年
12期
1212-1214
,共3页
马亚宾%王向宇%徐伟伟%龙青山%覃成箭
馬亞賓%王嚮宇%徐偉偉%龍青山%覃成箭
마아빈%왕향우%서위위%룡청산%담성전
体位%CT三维重建%颈静脉孔区%解剖
體位%CT三維重建%頸靜脈孔區%解剖
체위%CT삼유중건%경정맥공구%해부
Position%CT Three-D reconstruction%Jugular foramen area%Anatomy
目的 对比研究头颅正中前屈位与斜仰卧位对远外侧入路中颈静脉孔区(JF)周围结构的位移程度,为该区域手术入路及相关结构的保护提供解剖学依据. 方法 41例健康成人均经荷兰飞利浦电子公司64排CT机按骨窗条件以1mm层厚分别在头颅正中前屈位(即模拟术中侧卧位)与斜仰卧位进行连续轴位扫描,扫描范围包括外耳道水平至C3水平的骨性标志,扫描所得的图像输入飞利浦扩展华晨工作站进行CT的多平面重建(MPR),测量相关数据. 结果 在模拟侧卧位(即头颅正中前屈位)时测量寰椎横突(C1)至同侧乳突尖、茎突尖、枕髁外缘中点等解剖标志的距离分别为(20.99±4.18) mm、(20.49±5.47) mm、(22.035±4.27) mm.在斜仰卧位时测量寰椎横突至同侧乳突尖、茎突尖、枕髁外缘中点等解剖标志的距离、分别为(22.795±3.29) mm、(22.315±5.48) mm、(23.025±3.91) mm.与头颅正中前屈位比较,斜仰卧位时3段距离均较长,差异有统计学意义(P<0.05). 结论 经JF手术入路中,斜仰卧位可以改变相关结构间的相对空间位置关系,增加对颈静脉区的显露空间,使面神经、椎动脉、后组脑神经颅外段等结构得到保护,减少对周围组织结构的损伤及并发症的发生.
目的 對比研究頭顱正中前屈位與斜仰臥位對遠外側入路中頸靜脈孔區(JF)週圍結構的位移程度,為該區域手術入路及相關結構的保護提供解剖學依據. 方法 41例健康成人均經荷蘭飛利浦電子公司64排CT機按骨窗條件以1mm層厚分彆在頭顱正中前屈位(即模擬術中側臥位)與斜仰臥位進行連續軸位掃描,掃描範圍包括外耳道水平至C3水平的骨性標誌,掃描所得的圖像輸入飛利浦擴展華晨工作站進行CT的多平麵重建(MPR),測量相關數據. 結果 在模擬側臥位(即頭顱正中前屈位)時測量寰椎橫突(C1)至同側乳突尖、莖突尖、枕髁外緣中點等解剖標誌的距離分彆為(20.99±4.18) mm、(20.49±5.47) mm、(22.035±4.27) mm.在斜仰臥位時測量寰椎橫突至同側乳突尖、莖突尖、枕髁外緣中點等解剖標誌的距離、分彆為(22.795±3.29) mm、(22.315±5.48) mm、(23.025±3.91) mm.與頭顱正中前屈位比較,斜仰臥位時3段距離均較長,差異有統計學意義(P<0.05). 結論 經JF手術入路中,斜仰臥位可以改變相關結構間的相對空間位置關繫,增加對頸靜脈區的顯露空間,使麵神經、椎動脈、後組腦神經顱外段等結構得到保護,減少對週圍組織結構的損傷及併髮癥的髮生.
목적 대비연구두로정중전굴위여사앙와위대원외측입로중경정맥공구(JF)주위결구적위이정도,위해구역수술입로급상관결구적보호제공해부학의거. 방법 41례건강성인균경하란비리포전자공사64배CT궤안골창조건이1mm층후분별재두로정중전굴위(즉모의술중측와위)여사앙와위진행련속축위소묘,소묘범위포괄외이도수평지C3수평적골성표지,소묘소득적도상수입비리포확전화신공작참진행CT적다평면중건(MPR),측량상관수거. 결과 재모의측와위(즉두로정중전굴위)시측량환추횡돌(C1)지동측유돌첨、경돌첨、침과외연중점등해부표지적거리분별위(20.99±4.18) mm、(20.49±5.47) mm、(22.035±4.27) mm.재사앙와위시측량환추횡돌지동측유돌첨、경돌첨、침과외연중점등해부표지적거리、분별위(22.795±3.29) mm、(22.315±5.48) mm、(23.025±3.91) mm.여두로정중전굴위비교,사앙와위시3단거리균교장,차이유통계학의의(P<0.05). 결론 경JF수술입로중,사앙와위가이개변상관결구간적상대공간위치관계,증가대경정맥구적현로공간,사면신경、추동맥、후조뇌신경로외단등결구득도보호,감소대주위조직결구적손상급병발증적발생.
Objective To comparatively study the displacement of surrounding structures of jugular foramen (JF) via far lateral approach under middle cranial flexion supine and oblique supine,and to provide the anatomical basis for the protection of these relative structures during choosing regional surgical approaches.Methods Forty-one healthy adults were scanned by PHILIPS Brilliance 64-slice CT according to the conditions:1 mm thick bone window under the middle cranial flexion supine position and oblique supine positions,continuous axial scanning,and being ranged from horizontal canal to C3 levels bony landmarks.The scanned images were inputted Philips Extended Brilliance Workspace CT reconstruction of multi-plane (MPR) and the data were measured.Results In the middle cranial flexion supine position,the distances from transverse process atlas to the ipsilateral mastoid tip,tip of the styloid process,the midpoint of the outer edge in occipital condyle were (20.99±4.18) mm,(20.49±5.47) mm,and (22.035±4.27) mm.In the supine oblique position,the distances from transverse process atlasto the ipsilateral mastoid tip,tip of the styloid process,the midpoint of the outer edge in occipital condyle were (22.795±3.29) mm,(22.315±5.48) mm and (23.025±3.91) mm.Significant differences were noted in these three distances between the two positions (P<0.05).Conclusion In the JF surgical approach,supine oblique can change the relative spatial relationship of correlative structures,increase the exposure of the jugular vein area,therefore,protect the facial nerve,vertebral artery and posterior extracranial structures,and reduce the damage to surrounding structural tissues and the complications.