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目的 了解经乙状窦后入路切除内听道上方的骨质后手术视野增加的情况。方法 在 8× 40倍的手术显微镜下解剖测量 2 5具尸头 (共 5 0侧 )桥脑小脑角周围结构 ,切开三叉神经腔的硬脑膜壁和邻近天幕进一步扩大视野 ,并运用手术内窥镜观察海绵窦后部等结构。结果 磨除道上结节及其周围骨质可增加三叉神经腔的暴露范围大约 10 5mm ,并获得三叉神经后根的外侧和下方约 180°视角 ,借此可进入中颅窝后部。结论 该手术入路是切除起源于桥脑小脑角同时累及中颅窝、三叉神经腔肿瘤的良好途径 ,而不需要同时做幕上开颅手术。
Objective To investigate the increase of visual field after resection of the bone above the internal auditory canal by sigmoid sinus approach. Methods The structures around the cerebellopontine angle of 25 cadaveric heads (50 sides) were anatomically measured under an 8 × 40 times microscope. The dural wall of the trigeminal nerve was excised and the adjacent canopies were further excised to further expand the visual field. Looking at the end of cavernous sinus and other structures. Results Ablation of the supraspinatus and its surrounding bone can increase the exposure of the trigeminal lumen to approximately 10 mm and obtain a lateral and inferior view of the posterior root of the trigeminal nerve of about 180 °, allowing access to the posterior middle cranial fossa. Conclusion The surgical approach is a good way to remove the origin of the cerebellopontine angle while involving the middle cranial fossa and trigeminal cavity tumors without the need for simultaneous craniotomy.