窦三角区的显微解剖学研究

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目的 探讨窦三角区内各结构的形态和毗邻关系 ,以指导扩大的乙状窦前手术入路的手术操作。 方法 在手术显微镜下 ,对 10具尸体头颅标本按扩大的乙状窦前入路进行解剖 ;对 15个颅底窦三角区进行解剖观测 ;对 4个尸体头颅切片 ,制成 0 5~ 1 0mm超薄断层切片 ,对有关结构进行观测。 结果 静脉球可分为高位型、正常型和低位型。高位型出现率 ,左、右侧分别为 8%和18% ,两侧差异有非常显著性意义 (P <0 0 1) ;正常型出现率 ,左、右侧分别为 3 6%和 3 0 % ;低位型出现率左、右侧分别为 6%和 2 %。后半规管至岩部后表面水平距离为 ( 4 1± 1 1)mm。面神经管垂直段至颈静脉球间的距离 ,左、右侧分别为 ( 3 2± 0 5 )mm和 ( 2 0± 0 4 )mm。颈静脉球至内耳门后缘距离 ,左、右侧分别为 ( 7 5± 1 7)mm和 ( 4 0± 1 0 )mm。 结论 掌握窦三角区内各结构的形态和毗邻关系 ,有助于指导扩大的乙状窦前入路手术 ,预防重要结构的损伤 Objective To explore the morphology and adjacent relationship of each structure in sinus triangle to guide the operation of the enlarged sigmoid anterior approach. Methods Under the operation microscope, the anterior descending anterior sigmoid sinus of 10 corpses were dissected. Anatomical observation was made on 15 cranial sinus triangles. Four corpse cranial slices were made into 0 5 ~ 1 0 mm Ultrathin section, the structure of the observation. Results The venous ball can be divided into high type, normal type and low type. The incidence of high type, left and right were 8% and 18% respectively, with significant difference between the two sides (P <0.01). The incidence of normal type was 36% and 30% on the left and right %; Low incidence of left and right were 6% and 2%. The horizontal distance from the posterior semicircular canal to the posterior surface of the rock is (4 1 ± 1 1) mm. The distance between the vertical segment of facial nerve tube and the jugular bulb was (3 2 ± 0 5) mm and (2 0 ± 0 4) mm, respectively. The distance from the jugular bulb to the posterior border of the inner ear was (75 ± 1 7) mm and (4 0 ± 1 0) mm, respectively. Conclusion To master the morphology and adjacent relationship of each structure in sinus triangle can help guide the enlarged sigmoid anterior approach and prevent the damage of important structures
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