【摘要】 目的:详细了解桥小脑角蛛网膜的分布为认识听神经瘤和其手术提供解剖学依据。方法:采用10%福尔马林固定的胎儿(28-39周)尸头标本11例22侧,利用手术显微镜和常规组织切片染色方法观察内耳道及面、前庭蜗神经的膜性结构分布情况。结果:手术显微镜下见桥小脑池蛛网膜明显向内耳道内延续占81.81%(18侧),另18.19%(4侧)的蛛网膜向内延续的同时与内耳道口及神经发生部分的粘连;72.73%(16侧)的内耳道口及其附近存在大量的蛛网膜小梁与面、前庭蜗神经相连。组织切片发现100%(22侧)的内耳道内蛛网膜贴附在内耳道骨质表面延续至内耳道底部;面、前庭蜗神经之间互相独立,只有神经外膜分隔。结论:听神经瘤为蛛网膜内的结构;熟悉内耳道及面、前庭蜗神经的膜性结构有助于提高听神经瘤手术水平。更多还原

【Abstract】 Objective:To investigate the arachnoid mater of cerebellopontine angle(CPA) and provide detailed microanatomic basis for surgical therapy of acoustic neuroma.Methods: The distribution of cerebellopontine angle cistern’s arachnoid mater(CPACAM) was studied on 22 sides of 11 fetal head(28-39 weeks) specimen with operation microscope and common section-staining.Results:For 81.81% specimens(18 sides),the CPACAM directly stretched into internal acoustic cannal(IAC),however,the CPACAM of 18.19%(4 sides) adhered to the internal auditory foramen during its stretching to IAC.For 72.73% specimens(16 sides),arachnoid trabeculas connected the CPACAM with facial nerve and vestibulocochlear nerve at the internal auditory foramen.Staining showed that the CPACAM stretched on the surface of dura mater until the bottom of internal acoustic cannal in all sides and the epineurium was the boundary between cochlear nerve,superior vestibular nerve and inferior vestibular nerve.Conclusions:For improving acoustic neuroma operations,it is important to be familiar with anatomic structures of internal acoustic canal and its nerves.更多还原