【摘要】 目的:研究改良经颈静脉孔(JF)入路切除JF区颅内外沟通型肿瘤的技术及其暴露范围。方法:用彩色乳胶灌注10例成人带颈头颅湿标本后,显微镜下逐层解剖,研究JF区的血管、神经和硬膜等结构及与周围结构的解剖关系。结果:以枕下三角和横突为标志可以定位椎动脉水平段;以横突和肩胛提肌为标志可以确定椎动脉C2-C1段及保护后组颅神经、颈内静脉及颈内动脉。头外侧直肌可以定位JF后壁;磨除颈突可以暴露JF后壁;以髁导静脉为标志磨除颈静脉结节可暴露JF内侧壁;磨除乳突、岩骨鼓部,以鼓乳切迹为标志轮廓化面神经可以暴露JF外侧壁。结论:改良经颈静脉孔入路能从内、外、后、下等方向充分暴露JF,同时椎动脉、面神经及听力功能也得到很好的保护,是切除颅内外沟通型JF区肿瘤的理想入路。更多还原

【Abstract】 Aim:To study the improved JF approach for the jugular foramen lesions both intracranial and extracranial components.Methods:Cadaveric specimens of 10 cases (20 sides) with the colorized latex were anatomized and the JF and the adjacent structures were examined with magnification.Results: The horizen segment of the VA were exposured when detaching the suboccipital triangle and the transverse process.Detached the levator scapulae,the C2-C1 segment of the VA was freed;the rectus capitis lateralis was a landmark for the posterior wall of the JF;removal of the jugular process of the occipital, the exposure is directed to the posterior surface of the JF;to remove the jugular tubercle along the condylar emissary vein was to expose the medial surface of the JF;after remove of mastoid tip, the petrous bone was further drilled away to expose inferior to the labyrinth and the facial nerve. So, the exposure is extended lateral to the JF. Necessarly, the exposure can be extended according to the volum of lesions.Conclusion: The improved JF approach exposes the JF from posterior,laterior,inferior and medial, and the facial nerve, the vertebral artery and the hearing are preserved. It does well in the lesions both intracranial and extracranial components.更多还原