摘要
目的 介绍乳突后直切口枕下极外侧入路处理枕大孔区腹侧病变的有关解剖和手术技术要点。方法 4具尸体枕部解剖 6例 ,模拟手术操作过程 3例 ;6例手术实践体会。结果 乳突后直切口是从肌肉间隙中入路 ,涉及的肌肉只有部分的胸锁乳突肌、头夹肌 ,以及上、下斜肌 ,肌肉无需大范围的剥离切断。枕骨髁可磨除后 1/ 3。从椎动脉前方切开硬脊膜 ,视角可达 180度。能从颅脊神经和椎动脉的前方切除肿瘤 ,不牵延髓。从椎动脉后方切开硬脊膜 ,能处理低达颈 2、 3的肿瘤。结论 乳突后直切口枕下极外侧入路具有创伤小、手术视角好、对延髓牵拉轻微、切口易延扩和便于联合入路的优点。
Objective An extreme lateral approach was used to treat the lesions of anterior portion of foramen magnum. The operative tecnique and correlating anatomy are described. Methods Dissections and mimic operations were performed in 4 cadevers and surgical treatments were used for 6 paitients. Results A linear retromastoid skin incision was made. Muscles need to be divided as only sternocleidomastoid M., splenius capitis M., superior and inferior oblique M. The posterior 1/3 of the condyle was removed. Dura opened from front of the CVA, then we can resect the tumors from ventral aspect of the medulla and the angle of view attained 180 degree; dura opened from behind of the CVA, then we can manage the tumors extending downword to the C 2, 3 level. Conclusions Linear retromastoid incision suboccipital extreme lateral approach can provide a good surgical field and avoid retraction of brain, and can be easily combined with other approach.
出处
《中华神经外科杂志》
CSCD
北大核心
2001年第5期309-312,共4页
Chinese Journal of Neurosurgery
关键词
神经外科手术
枕下极外侧入路
局部解剖
枕大孔区
Neurosurgical operation Suboccipital extreme lateral approach Topograghy Foramen magnum region
