■为了研究颞下经脑干外侧入路的微解剖结构,并提供解剖学信息,以帮助临床医生在外侧进行手术,圆周,和脑干的岩壁区域。
■对8个尸体头部标本(16侧)进行了解剖学研究。头部向一侧倾斜,颧骨弓在最高点.然后,在耳廓上方做了一个马蹄形切口。切口从the弓的中点延伸到横窦的中外侧长度的三分之一,皮瓣转向颞部。切除骨头后,在显微镜下小心地剥离蛛网膜和软脑膜。观察手术入路的暴露范围,明确入路中相关神经和血管的位置关系。拍摄了重要结构并测量了相关参数。
■the根的上边缘可用于精确定位中颅窝的基部。恒星的平均距离指向乳突的顶点,星星指向外耳道的上脊,顶乳突缝合到外耳道上脊的前角度,10例成人颅骨标本的顶乳突缝合与星点的前角为47.23mm,45.27mm,26.16mm,和23.08毫米,分别。颞下入路可以完全暴露该区域,从高到后斜突,低到岩脊和弓形突起,然后穿过小脑的小脑。该方法可以处理中部斜坡腹侧或外侧的病变,水箱氛围,中脑,中脑,还有Pons.此外,该方法可以通过che骨切除显着扩大小脑幕上部的暴露面积,并通过岩骨研磨技术扩大小脑幕下部的暴露范围。滑车神经的总长度,滑车神经到小脑的触脑边缘的距离,它的形状在天幕夹层中的长度,其进入岩脊小脑幕的下部为(16.95±4.74)mm,(1.27±0.73)mm,(5.72±1.37)mm,(4.51±0.39)mm,分别。小脑幕可以通过后斜突或弓形突起安全地打开以进行定位。动眼神经可以作为定位大脑后动脉和小脑上动脉的解剖学标志。
■通过显微解剖研究,可以明确颞下经幕入路的暴露范围和术中困难,这有助于临床医生准确安全地计划手术方法并减少手术并发症。
UNASSIGNED: To study the microanatomic structure of the subtemporal transtentorial approach to the lateral side of the brainstem, and to provide anatomical information that will assist clinicians to perform surgeries on the lateral, circumferential, and petroclival regions of the brainstem.
UNASSIGNED: Anatomical investigations were conducted on 8 cadaveric head specimens (16 sides) using the infratemporal transtentorial approach. The heads were tilted to one side, with the zygomatic arch at its highest point. Then, a horseshoe incision was made above the auricle. The incision extended from the midpoint of the zygomatic arch to one third of the mesolateral length of the transverse sinus, with the flap turned towards the temporal part. After removing the bone, the arachnoid and the soft meninges were carefully stripped under the microscope. The exposure range of the surgical approach was observed and the positional relationships of relevant nerves and blood vessels in the approach were clarified. Important structures were photographed and the relevant parameters were measured.
UNASSIGNED: The upper edge of the zygomatic arch root could be used to accurately locate the base of the middle cranial fossa. The average distances of the star point to the apex of mastoid, the star point to the superior ridge of external auditory canal, the anterior angle of parietomastoid suture to the superior ridge of external auditory canal, and the anterior angle of parietomastoid suture to the star point of the 10 adult skull specimens were 47.23 mm, 45.27 mm, 26.16 mm, and 23.08 mm, respectively. The subtemporal approach could fully expose the area from as high as the posterior clinoid process to as low as the petrous ridge and the arcuate protuberance after cutting through the cerebellar tentorium. The approach makes it possible to handle lesions on the ventral or lateral sides of the middle clivus, the cistern ambiens, the midbrain, midbrain, and pons. In addition, the approach can significantly expand the exposure area of the upper part of the tentorium cerebelli through cheekbone excision and expand the exposure range of the lower part of the tentorium cerebelli through rock bone grinding technology. The total length of the trochlear nerve, distance of the trochlear nerve to the tentorial edge of cerebellum, length of its shape in the tentorial mezzanine, and its lower part of entering into the tentorium cerebelli to the petrosal ridge were (16.95±4.74) mm, (1.27±0.73) mm, (5.72±1.37) mm, and (4.51±0.39) mm, respectively. The cerebellar tentorium could be safely opened through the posterior clinoid process or arcuate protrusion for localization. The oculomotor nerve could serve as an anatomical landmark to locate the posterior cerebral artery and superior cerebellar artery.
UNASSIGNED: Through microanatomic investigation, the exposure range and intraoperative difficulties of the infratemporal transtentorial approach can be clarified, which facilitates clinicians to accurately and safely plan surgical methods and reduce surgical complications.