目的:硬膜外神经轴室(EDNAC)是位于硬膜的脑膜(ML)和内膜(EL)层之间的脂肪静脉区,在颈静脉孔(JF)区域进行了少量研究。在这项研究中,作者旨在探索JF中EDNAC的精细架构,并评估EDNAC是否可用作JF划分的组件.
方法:共有46具尸体头部(31名男性,15名女性;年龄范围54-96岁)和30个干头骨在这项研究中进行了检查。46个尸体头中的12个被塑化为一系列横向(7组),日冕(3套),和矢状(2组)切片,并使用立体显微镜和共聚焦显微镜检查。在34个尸体头骨中记录了JF颅神经的硬脑膜进入点。JF的卷,椎间孔EDNAC,和颈内静脉(IJV)进行了量化。
结果:基于恒定的骨标志,JF被细分为前孔,椎间孔,和椎间孔下节段。沿着IJV前内侧壁的ML衍生的筋膜鞘划定了两段JF的“静脉部分”和“EDNAC部分”。EDNAC不围绕椎间孔内IJV,并包含ML衍生的硬脑膜纤维网络和脂肪基质。纤维静脉幕将椎间孔内EDNAC细分为包含颅神经(CN)IX和前髁静脉丛的小前柱和包含CNX和XI的大的后脂肪柱。在椎间孔段,IJV在孔占据了稍大的空间(57%;p<0.01),而在椎间孔下段,它占据了与EDNAC相似大小的空间。
结论:不包括IJV,JF中的神经血管结构穿过在椎间孔EDNAC中占主导地位的硬脑膜纤维网络。这项研究的结果将有助于对晦涩但至关重要的JF区域的解剖学知识,增加对椎间孔肿瘤生长和扩散模式的了解,并促进外科手术的计划和执行。
The extradural neural axis compartment (EDNAC) is an adipovenous zone that is located between the meningeal (ML) and endosteal (EL) layers of the dura mater and has been minimally investigated in the jugular foramen (JF) region. In this
study, the authors aimed to explore the fine architecture of the EDNAC within the JF and evaluate whether the EDNAC can be used as a component for JF compartmentalization.
A total of 46 cadaveric heads (31 male, 15 female; age range 54-96 years) and 30 dry skulls were examined in this
study. Twelve of 46 cadaveric heads were plastinated as a series of transverse (7 sets), coronal (3 sets), and sagittal (2 sets) slices and examined using stereomicroscopy and confocal microscopy. The dural entry points of the JF cranial nerves were recorded in 34 cadaveric skulls. The volumes of the JF, intraforaminal EDNAC, and internal jugular vein (IJV) were quantified.
Based on constant osseous landmarks, the JF was subdivided into preforaminal, intraforaminal, and subforaminal segments. The ML-derived fascial sheath along the anteromedial wall of the IJV demarcated the \"venous portion\" and the \"EDNAC portion\" of the bipartite JF. The EDNAC did not surround the intraforaminal IJV and comprised an ML-derived dural fibrous network and an adipose matrix. A fibrovenous curtain subdivided the intraforaminal EDNAC into a small anterior column containing cranial nerve (CN) IX and the anterior condylar venous plexus and a large posterior adipose column containing CNs X and XI. In the intraforaminal segment, the IJV occupied a slightly larger space in the foramen (57%; p < 0.01), whereas in the subforaminal segment it occupied a space of similar size to that of the EDNAC.
Excluding the IJV, the neurovascular structures in the JF traverse the dural fibrous network that is dominant in the foraminal EDNAC. The results of this
study will contribute to anatomical knowledge of the obscure yet crucially important JF region, increase understanding of foraminal tumor growth and spread patterns, and facilitate the planning and execution of surgical interventions.