摘要
目的:对经蝶海绵窦手术中相关动脉结构的解剖学数据和形态学特点进行研究,为临床手术提供解剖学基础;方法:取动脉灌注的固定尸头标本10例20侧(6男4女),通过经蝶手术暴露鞍旁段颈内动脉(PSICA)后,小心分离各动脉分支,对其进行解剖学描述,并和经颅手术中海绵窦内血管结构进行对比;结果:经蝶入路颈内动脉可分为PSICA和斜坡旁段颈内动脉(PCICA),打开海绵窦下壁即暴露PSICA,根据其形态可分为上、下水平部和垂直部,脑膜垂体干源于PSICA下水平部末段内壁占45%(9侧)、顶壁占20%(4侧)、外壁占25%(5侧)、上水平部中段内壁占10%(2侧);海绵窦下动脉源于PSICA垂直部中段外壁占80%(16侧),下水平部中段占5%(1侧);另15%(3侧)源于脑膜垂体干;仅在25%标本(5侧)中发现McConnell’s背囊动脉,其源于垂直部上段的内壁上,口径细小(0.85±0.21)mm;结论:经蝶入路中,向内侧走行的动脉分支是出血的主要原因,了解相关动脉结构在解剖形态上的变化,对于减少术中出血、外科安全治疗具有重要意义。
Objective： To demonstrate anatomical data and morphological characteristics of arteries in cavernous sinus （CS） and provide anatomical guides for treatment of lesions involving CS. Me,hods： Ten fixed cadavers＇ heads （six male, four female）, the arteries of which were injected with red latex, were used to perform transsphenoidal approach. The anterior wall of sphenoidal sinus and the floor of sellar turcica were opened as possible to expose floor dura mater of sella and inferior wall of CS. Then all branches of parasellar internal carotid artery （PSICA） were dissected carefully. Anatomical data and morphological characteristics of these branches were measured and demonstrated, the result of which were compared with those from transcranial approach. Results： According to morphological charateristics, ICA in CS could be divided to two parts： PSICA and paraclival ICA （PCICA） in transsphenoidal approach. The PSICA could be subdivided into three parts： upper, lower horizontal and vertical part. In 9 of 20 sides CS （45%）, Meningohypophyseal trunk originated from medial wall of inferior horizontal part ofPSICA, 4 sides （20%） from the roof wall, 5 sides （25%） from lateral wall, 2 sides （10%） from medial wall of superior horizontal part. In 16 of 20 sides （80%）, The inferolateral trunk （artery of the inferior cavernous sinus） arised from the lateral wall of vertical part, 1 sides （5%） from inferior horizontal part, 3 sides （15%） from meningohypohyseal trunk. McConnelrs capsular arteries were only found in 5 sides （25%） of all species, which arised from the medial side of vertical part. The diameter of this artery was about 0.85＋0.21mm, which was smaller than another branch of ICA. Conclusions： In transsphenoidal approach, because of the change of optic view and field, the morphological features of ICA in CS and intracavernous branches in transsphenoidal approach are different from those in transcranial approach. The branches, which coursed medially, are a
出处
《中国临床解剖学杂志》
CSCD
北大核心
2006年第5期489-492,497,共5页
Chinese Journal of Clinical Anatomy
基金
广东省重点攻关项目(C31204)
关键词
经蝶人路
海绵窦
解剖学
颈内动脉
transsphenoidal approach
cavernous sinus
anatomy
internal carotid artery
