摘要
目的本研究旨在提供准确、全面的颅颈交界区及其周围解剖学结构数据,提供避免相关手术并发症发生的解剖数据。方法本研究120例患者血管造影图像进行了回顾,在三维体积重建后分别在冠状位、矢状位和轴位进行了相关结构的测量。以门齿为基准,定位咽结节、枕骨大孔以及寰椎前结节,同时对其他重要的骨性标志、颈内动脉和椎动脉进行充分研究,以此确定经口咽入路的最佳角度与深度,从而避免在手术中伤及这些结构。结果在颅颈交界区的神经内镜手术中,内镜的弯转角度14.27±4.51℃,进入深度应约为72.57±8.72 mm。在枕骨大骨水平,(横切面)轴位平面内安全手术的角度为77.73±3.15℃,而轴位中线处,安全穿透宽度为20.05±3.11 mm。从轴位中线M到舌下神经管内口,颈动脉管外口(CC)和颈静脉内缘(JF)的距离分别为9.78±0.72 mm、24.50±1.26 mm和24.33±1.68mm。结论本数据有助于理解颅颈交界区周围的解剖学结构,降低手术并发症发生以及最大限度地提高手术的安全性。
Objective This study aims to provide accurate and comprehensive data of craniocervical junction and its peripheral structures in order to provide a profound insight of craniocervical junction as well as to avoid complications during surgical procedures related to it.Method Computer topographic angiography images of 120 individuals were reviewed,the measurements were performed on coronal,sagittal and axial planes after threedimension volume reconstruction.We measured pharyngeal tubercle,foramen magnum and tuberculum anterius atlant which located based on the position of incisor.The anatomic features of other important bony landmarks,internal carotid artery and vertebral artery were also fully studied so as to avoid being injured during the transoral-transpharyngeal procedure.Results During the endoscopic surgery to craniocervical junction,the bending angle of neuro endoscopy should be 14.27±4.51℃and the entering depth should be about 72.57±8.72 mm.It is safe to work within the angle of 77.73±3.15℃in axial plane and the safe penetration width from the axial midline is 20.05±3.11 mm in the level of foramina magnum.The distance from axial middle line M to hypoglossal canal,external opening of carotid canal(CC)and inner edge of jugular foramen(JF)was 9.78±0.72 mm,24.50±1.26 mm and 24.33±1.68 mm,respectively.Conclusion The data in this study are valuable for neurosurgeons in clinical practice to reduce the possibility of complications and maximize the safety of surgeries,these data also contribute to the understanding of the anatomy of craniocervical junction and its surrounding structures.
作者
王新慧
姜姗姗
胡芳菲
葛琳娜
钟升
任佳欣
姜淑娥
Wang Xinhui;Jiang Shanshan;Hu Fangfei;Ge Linna;Zhong Sheng;Ren Jiaxin;Jiang Shue(Department of Oncology,the First Hospital of Jilin University,Changchun 130021,China)
出处
《脑与神经疾病杂志》
2020年第7期397-401,共5页
Journal of Brain and Nervous Diseases
基金
吉林省发展计划项目(20160101086JC)
关键词
解剖学关系
颅颈交界区
经口咽入路手术
Anatomical relationship
Craniocervical junction
Transoral-transpharyngeal surgery
