【摘要】 目的　探讨经小脑延髓裂入路到达第四脑室和脑干侧方的组织结构间关系 ,以指导手术入路。方法　应用显微外科解剖学技术 ,对经甲醛固定、血管内灌注彩色乳胶的 1 0具成人尸头标本 ,按手术入路逐层解剖。观察脉络膜、第四脑室顶、菱形窝、小脑后下动脉等组织血管形态结构。结果　经小脑延髓裂入路 ,可通过脉络膜、下髓帆及蚓小结到达菱形窝的任何部位 ,通过外侧隐窝到达脑桥和延髓的背外侧。小脑后下动脉的扁桃体延髓段和膜髓帆扁桃体段是该入路涉及的重要血管。结论　经小脑延髓裂入路通过正常的解剖间隙到达第四脑室和脑干的侧方 ,可减少对组织的损伤 ,提高手术疗效更多还原

【Abstract】 Objective To study the anatomy of structures on the way to the fourth ventricle of cerebrum via transcerebellomedullary fissure approach. Methods Ten cadaveric heads fixed with formalin and with their arteries and veins perfused with color latex were dissected with nicrosurgical anatomical skills to observe the structure of tela choroida, fourth ventricle roof, rhomboid fossa, and posterior inferior cerebellar artery (PICA) and its branches. Results Via the transcerebellomedullary fissure approach, any part of the rhomboid fossa can be reached by exposing and separating the tela choroida, inferior medullary velum, and nodule of vermis, and the dorsolateral part of pons and of medulla obligata can be reached by lateral recess. Conclusion The fourth ventricle of cerebrum and the lateral parts of brainstem can be reached via transcerebellomedullary fissure approach through normal anatomical spaces. The tonsilomedullary and telovelotonsillar segments of PICA are the most important vessels in the transcerebellomedullary fissure approach.更多还原