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目的研究颅神经微血管减压术的枕下乙状窦后入路相关解剖,为临床手术提供解剖学资料。方法 10%甲醛固定并灌注乳胶的中国人成人头颅湿性标本8例,模拟手术入路,逐层解剖、观察桥小脑角区解剖和主要血管神经,重点研究上、中、下神经血管复合体的解剖和毗邻关系。结果三叉神经入脑干区与乙状窦横窦移行处的距离为(4.4±0.2)cm,面神经出脑干区与乙状窦横窦移行处距离为(4.1±0.2)cm,桥小脑池的宽度为(0.2±0.1)cm,小脑绒球高度为(0.3±0.1)cm。结论通过经枕下乙状窦后入路,解剖桥小脑角区神经血管,研究骨窗、岩静脉,上、中、下神经血管复合体,充分认识各个重要神经和血管结构毗邻关系,对手术有重要指导意义。
Objective To study the anatomy of the suboccipital sigmoid sinus posterior approach for cranial nerve microvascular decompression and provide anatomical data for clinical operation. Methods Eight adult Chinese male adult patients with formalin fixed and infused with latex were enrolled in this study. They were modeled by surgical approach and anatomized layer by layer. The anatomy of the cerebellopontine angle and the major vascular nerves were observed. The focus was on the study of the neurovascular complex Anatomy and adjacency. Results The distance between the trigeminal nerve and the transverse sinus of the sigmoid sinus in the brainstem area was (4.4 ± 0.2) cm. The distance between the facial nerve root and the transverse sinus of the sigmoid sinus was (4.1 ± 0.2) cm, (0.2 ± 0.1) cm in width and (0.3 ± 0.1) cm in cerebellum. Conclusion Through the transoccipitally posterior sigmoid sinus approach to dissect the neurovascular structures of the cerebellopontine angle region, study the bone window, petrosal vein, upper, middle and lower neurovascular complex, fully understand the relationship between the various important nerve and vascular structure, Have important guiding significance.