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目的：通过对侧颅底区神经血管的临床应用解剖学观察，为术中保全脑神经和重要血管提供解剖学基础。方法：对２１侧成人尸头按ＦｉｓｃｈＡ、Ｂ型颞下窝手术进路进行解剖，观察颈静脉球区域神经血管解剖关系；观察颈内动脉及毗邻的解剖关系。结果：颈静脉球可分为隆起型（占６６．７％）和低平型（占３３．３％）。岩下窦开口部位有三种类型。Ⅸ脑神经多位于颈静脉球的前内侧，Ⅹ、Ⅺ脑神经多位于其内侧。Ⅺ脑神经与岩下窦末端关系密切，可分三种类型。颈内动脉水平段距鼓膜张肌平均为２．２ｍｍ，距脑膜中动脉和下颌神经分别平均为６．８ｍｍ和６．９ｍｍ。结论：避免手术损伤后脑神经的关键是充分暴露，辨认清楚后明视下操作。鼓膜张肌、脑膜中动脉、下颌神经是预测和辨认颈内动脉水平的良好标志。
OBJECTIVE: To provide an anatomical basis for the preservation of cranial nerves and important blood vessels during operation through anatomic observation of the neurovascular vessels in the lateral skull base. Methods: 21 adult cadaver heads were dissected according to FischA and B infratemporal fossa approach. The anatomic relationship of the neurovascular vessels in the jugular bulb was observed. The anatomic relationship between the internal carotid artery and its adjacent organs was observed. Results: Jugular bulb can be divided into bulge type (66.7%) and low type (33.3%). There are three types of petrosal sinus openings. Ⅸ brain nerve in the jugular bulb in front of the medial, Ⅹ, Ⅺ cranial nerves located in the medial. Ⅺ brain and petrous sinus distal end of the relationship can be divided into three types. The level of internal carotid artery from the tympanic membrane muscle average of 2.2mm, from the middle of the meningeal artery and mandibular nerve averaged 6.8mm and 6.9mm. Conclusion: The key to avoiding cranial nerves after surgical injury is to fully expose, identify clearly and visually under the operation. Tympanic membrane, middle meningeal artery, mandibular nerve is a good marker to predict and identify the level of the internal carotid artery.