摘要
目的探讨极外侧小脑上天幕下入路的手术方法及该入路可暴露的解剖范围。方法对10具动静脉灌注的头颅湿标本于导航辅助下模拟极外侧小脑上天幕下入路显微手术,观测手术全程及术野暴露范围。结果极外侧小脑上天幕下入路可以充分暴露天幕切迹侧方区域、环池、中脑背外侧、滑车神经及伴行的小脑上动脉、大脑后动脉(P2、P3段)、脉络膜后内侧动脉及后方的四叠体池外侧方,切开天幕可以显露海马旁回后部;轮廓化乙状窦和横窦有利于对脑干外侧及对应天幕切迹侧后区域的暴露。结论极外侧小脑上天幕下入路适合于脑干背外侧及与之相对应的天幕切迹区域病变手术。
Objective To explore the surgical procedures and the exposed area of extremely lateral supracerebellar infratentorial approach. Methods Neuronavigation assisted microsurgery via extremely lateral supracerebellar infratentorial approach was simulated on ten wet adult cadaveric heads, and the surgical procedure and surgical field were observed. Results By this approach, the operative exposure can cover the lateral tentorial incisura, ambient cisterns, dorsolateral mesencephalon, trochlear nerve and the accompanying superior cerebellar artery, posterior cerebral artery （P2 and P3）, medial posterior choroidal artery and lateral quadrigeminal cistern. The skeletonization of the sigrnoid sinus and transverse sinus enlarged the view of the lateral brainstem and latero-posterior region of the tentorial incisura corresponding to it. Conclusion The extremely lateral supracerebellar infratentorial approach is a reasonable choice for exposing the dorsolateral brainstem and region of the tentorial incisura corresponding to it.
出处
《中国微侵袭神经外科杂志》
CAS
北大核心
2009年第3期125-128,共4页
Chinese Journal of Minimally Invasive Neurosurgery
基金
南京市医学科技发展项目(YKK06122)
关键词
极外侧小脑上天幕下入路
神经解剖学
天幕切开
extreme lateral supracerebellum infratentorial approach
neuroanatomy
tentorium cerebelli hiatus incision
