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目的 分析健康成人当下颌骨处在正常牙尖交错位时 ,髁突与颅底颈内动脉管外口、颈静脉窝、卵圆孔、棘孔、破裂孔等之间的空间位置关系 ,为术中对其他重要结构的位置评估提供依据。方法 选择健康成人 10 0名 ,在正常牙尖交错位时 ,用螺旋CT扫描、颅底三维影像重建 ,测量各结构间的最短距离和空间角度。 12个定点 ,测量 2 8项距离和空间角度以极坐标表示 ,髁突内缘点为中心点 ,髁突长轴为 0°轴作为参照系。结果 颌下入路能顺利显露髁突内缘点和髁突长轴的方向 ,以此为参照系 ,确定颈内动脉管外口外缘点为 12 0 1± 2 71mm ,5 14± 1 2 2° ,颈静脉窝外缘点为 15 11±2 72mm ,- 5 6 2 7± 14 0 5°。结论 以髁突内缘点为中心点 ,髁突长轴为 0°轴参照系有助于为颌下入路颅底手术的术中定位及颅底解剖教学提供参考。
Objective To analyze the spatial relationship between the condyles and the external carotid artery of the skull base, the jugular fossa, the foramen ovale, the foramen ovale, the ruptured foramen, etc. when the mandible of the healthy adults are in the normal cusp position. Intraoperative evaluation of other important structures to provide the basis. Methods A total of 10 healthy adults were selected. During the normal cusp position, the shortest distance and the spatial angle of each structure were measured by helical CT scan and skull base 3D reconstruction. 12 fixed points, measuring 28 distances and spatial angles in polar coordinates, the condylar point of the inner edge as the center point, the long axis of the condylar axis of 0 ° as the reference frame. Results The submandibular approach successfully revealed the direction of the condylar medial point and the long axis of the condylar. Using this as the reference frame, the external points of the external carotid artery were identified as 12 0 1 ± 2 71mm and 5 14 ± 1 2 2 °, the outer margin of jugular fossa was 15 11 ± 2 72mm, -5 567 ± 14 0 5 °. Conclusions The condylar medial point as the center point, the condylar long axis of 0 ° axis reference system is helpful to provide references for intraoperative positioning of skull base surgery and skull base anatomy teaching.