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Microsurgical anatomy of anterior clinoid process region through Dolenc approach
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- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF NEUROMEDICINE
- Issue:
- 6
- DOI:
- 10.3760/cma.j.issn.1671-8925.2003.06.004
- Key Word:
- 前床突区;海绵窦;Dolenc入路;显微外科解剖
Abstract： 目的为经Dolenc入路处理前床突区病变提供显微外科解剖学基础.方法模拟经Dolenc入路对15具(30侧)防腐尸头在手术显微镜下进行解剖、观测.结果ACP、ICA及其分支与大脑后动脉形成外、内侧及上解剖三角.ACP磨除后可见ICA床突段,远环分开ICA C2段与C3段,也是ICA进入CS内外的分界线.远环内侧部分不完整,可形成ICA凹陷动脉瘤,突向硬膜外.近环的一部分将ICA床突段与动眼神经分开,与视神经嵴相连.近环疏松可有CS静脉丛.结论(1)ACP区各解剖三角的划分对于选择手术入路有重要的临床意义,外侧、上三角区病变适合于Dolenc入路;(2)ACP磨除可显著增加ACP区和鞍上区的显露,Do1enc入路+ACP磨除是经CS手术操作的关键步骤;(3)ICA C3段可位于CS内或外,视神经嵴可作为定位ACP区动脉瘤可靠的解剖学标志.
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