【摘要】 目的研究经后颞下入路-经天幕暴露岩斜区及小脑桥脑角的神经内镜下血管神经解剖结构,探索岩斜区及小脑桥脑角可利用的间隙。方法成年新鲜尸头9例(18侧),交替使用0°、30°角神经内镜经后颞下入路-经小脑幕探查岩斜区及小脑桥脑角,并用摄像系统对相关的解剖结构及解剖标志纪录。结果小脑桥脑角在神经内镜下分为结构清晰的上、中、下三个间隙,三个间隙均有充分的操作空间,分别经三个间隙推进神经内镜后岩斜区得以暴露。结论神经内镜下经后颞下入路-经天幕能充分的暴露岩斜区、小脑桥脑角及周边解剖结构。更多还原

【Abstract】 Objective To study more accurate topograph of nervous and vascular anatomy structure within the regions of petroclival junction and cerebellopontine angle via posterior subtemporal keyhole and transtentorial approach by using endoscope, and then to find out the useful compartments available for endoscope entrance. Methods 9 fresh adult cadaveric heads were studied with rigid WOLF fiberoptic rod endoscopes of varying viewing angles: 0°and 30°. Using posterior subtemporal keyhole, petroclival junctions and cerebellopontine angles of 9 fresh adult cadaveric heads were easily exposed, simultaneously recording the details of the cranial nerves, and vascular orientation, even more importantly, noting the relationships between superior cerebellar artery and the CN V , the anterior inferior cerebellar artery and CNⅦ, CNⅧ, and so on. Results The cerebellopontine angle endoscopically consisted of three unique operative compartments, and they were as follows: (1) the upper compartment, (2) the mid-compartment, (3) the lower compartments. The upper rim of hypoglossal canal and jugarlar foramen were sawn under the use of 30-degree angled neuroendoscope after avoided jugular bulb. A wide view of the foramen magnum and lower clivus environment were obtained through angled endoscope. Conclusion Owing to employing the natural intracranial compartments, petroclival junction and CPA, even no less than small part of clivus, are all exposed via endoscopic keyhole approaches of the posterior temporal region, and the operative scathe is minimized to the lowest extent.更多还原