海绵窦三角的显微外科解剖

The microanatomy of the cavernous sinus trigones

  • 摘要: 目的:了解海绵窦(Cavemoussinus,CS)有关的三角的显微解剖,为CS病变直接手术提供安全术入路。方法:20例成人头部标本,在显微镜下对CS颅内三壁有关三角进行解剖观察和测量。结果:CS上壁内有前内侧三角、内侧三角、颈动脉三角和动眼三角;外壁内及其附近有旁内侧三角、Parkinson三角、Mulan三角、外侧三角、Glasscock三角和Kawase三角:后壁上有下外侧三角和下内侧三角。结论:CS三角为其病变直接手术提供既不损伤重要神经血管又能进入CS内的安全手术入路。临床上最常应用的额颞骨瓣(翼点入路)CS上壁和外壁联合入路就是经内侧三角和Parkinson三角进入CS的。

     

    Abstract: Objective: Understanding the microanatomical structures of the trigones related to the cavernous sinus (CS) in order to provide safe operative approaches for direct microsurgical operation to the CS. Methods: Twenty adult cadaver heads were used to anatomize, observe and measure the trigones in three CS walls facing to the brain under microscope. Results: 12 trigones were observed in CS. They were anteromedial trigone, medial trigone, carotid trigone and oculomotor trigone in the superior wall of the CS; Lateromedial trigone, Parkinson trigone, Mullan trigone, lateral trigone, Glasscock trigone and Kawase trigone in/near the lateral wall. Inferolateral trigone and inferomedial trigone in the posterior wall. Conclusion: The trigones of the CS may provide safe approches for direct operation to CS, which can make us do the following good: entering the CS without injuring some important nerves and arteries. Clinicallly, the most used combined approach(Pterional Approach, frontotemperal bone flap used)is throuth the superior and lateral walls of the CS which the midial and Parkinson trignes is usually through.

     

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