内镜下经口入路至颈静脉孔区处理沟通型肿瘤的临床应用解剖

王涵, 王玉海

中国临床解剖学杂志 ›› 2018, Vol. 36 ›› Issue (1) : 5-9.

中国临床解剖学杂志 ›› 2018, Vol. 36 ›› Issue (1) : 5-9. DOI: 10.13418/j.issn.1001-165x.2018.01.002
应用解剖

内镜下经口入路至颈静脉孔区处理沟通型肿瘤的临床应用解剖

  • 王涵, 王玉海
作者信息 +

Applied anatomy of the endoscopic transoral approach in treatment of the jugular foramen region communicating tumors

  • WANG Han, WANG Yu-hai
Author information +
文章历史 +

摘要

目的 研究内镜下经口入路至颈静脉孔区解剖,以期为临床上切除该区域的沟通型肿瘤提供解剖学依据。  方法 在内镜下对15具尸头模拟经口入路,观察颈静脉孔区颅内外的暴露情况,定位解剖标志并记录相关参数。  结果 内镜下经口入路可很好显露颈静脉孔区颅外段,尤其是其前内侧区域,在磨除舌下神经管外口至中线骨质后可获得颅内脑干腹侧中线区域的最佳暴露。枕髁、髁上槽、颈动脉嵴为重要的解剖标志。其中枕髁前缘距舌下神经管外口下缘(14.51±2.30) mm,枕髁前缘距颈动脉嵴(24.11±2.19) mm,枕髁前缘距颈静脉结节上端(21.26±2.26) mm。   结论 该入路有助于处理肿瘤主体偏于颈静脉孔内侧的沟通型肿瘤。

Abstract

Objective Study on anatomy of endoscopic transoral approach to jugular foramen, in order to the application of this approach to remove the communicating tumor in jugular foramen region.  Methods With the aid of endoscope,15 cadaveric head specimens were used to simulate transoral approach to jugular foramen. The extracranial and intracranial structures of jugular foramen were observed, the anatomic landmarkers were located and the relevant data measured. Results Transoral approach could reveal extracranial region of jugular foramen well, especially the anterior medial region. The best exposure to the midline region of the brain stem was obtained after removing the bone from the external opening of the hypoglossal canal to the midline of the clivus. The occipital condyle, supracondylar groove and carotid ridge were important anatomical landmarks in this approach. The distance was (14.51±2.30) mm from the anterior edge of the occipital condyle to inferior edge of the external opening of the hypoglossal canal. The distance was (24.11±2.19) mm from anterior edge of the occipital condyle to carotid ridge. The distance was (21.26±2.26) mm from anterior edge of the occipital condyle to the upper edge of the jugular tubercle. Conclusion  This approach is helpful in dealing with the principal part of tumors in the medial region of the jugular foramen.

关键词

颈静脉孔区 / 内窥镜 / 沟通型肿瘤 / 经口入路 / 应用解剖

Key words

Jugular foramen / Endoscope / Communicating tumors / Transoral approach / Applied anatomy

引用本文

导出引用
王涵, 王玉海. 内镜下经口入路至颈静脉孔区处理沟通型肿瘤的临床应用解剖[J]. 中国临床解剖学杂志. 2018, 36(1): 5-9 https://doi.org/10.13418/j.issn.1001-165x.2018.01.002
WANG Han, WANG Yu-hai. Applied anatomy of the endoscopic transoral approach in treatment of the jugular foramen region communicating tumors[J]. Chinese Journal of Clinical Anatomy. 2018, 36(1): 5-9 https://doi.org/10.13418/j.issn.1001-165x.2018.01.002

参考文献

[1]  Samii M, Babu RP, Tatagiba M, et al. Surgical treatment of jugular foramen schwannomas[J]. Journal of Neurosurgery, 1995, 82(6):924-932.
[2]  Snyderman CH, Pant H, Carrau RL, et al. What are the limits of endoscopic sinus surgery?: the expanded endonasal approach to the skull base[J]. Keio Journal of Medicine, 2009, 58(3):152.
[3]  Dallan I, Bignami M, Battaglia P, et al. Fully endoscopic transnasal approach to the jugular foramen: anatomic study and clinical considerations[J]. Neurosurgery, 2010, 67(3 Suppl Operative):1-8.
[4]  Lee DLY, Mccoul ED, Anand VK, et al. Endoscopic Endonasal Access to the Jugular Foramen: Defining the Surgical Approach[J]. Journal of Neurological Surgery Part B Skull Base, 2012, 73(5):342.
[5] Shin M, Kondo K, Hanakita S, et al. Endoscopic transsphenoidal anterior petrosal approach for locally aggressive tumors involving the internal auditory canal, jugular fossa, and cavernous sinus.[J]. Journal of Neurosurgery, 2016, 126(1):1.
[6]  Komune N, Matsushima K, Matsushima T, et al. Surgical approaches to jugular foramen schwannomas: An anatomic study[J]. Head & Neck, 2016, 38 Suppl 1(S1):E1041-E1078.
[7]  Borba LA, Araújo JC, de Oliveira JG, et al. Surgical management of glomus jugulare tumors: a proposal for approach selection based on tumor relationships with the facial nerve.[J]. Journal of Neurosurgery, 2010, 112(1):88.
[8]  Griessenauer CJ, Mcgrew B, Matusz P, et al. Surgical Approaches to the Jugular Foramen: A Comprehensive Review.[J]. J Neurol Surg B Skull Base, 2015, 77(03):260-264.
[9]  徐领领, 王玉海. 两种联合入路处理颈静脉孔区沟通性肿瘤的应用解剖比较[J]. 中国临床解剖学杂志, 2017, 35(4):361-366.
[10]He J, Wan JH, Zhao B, et al. Dumbbell-shaped jugular foramen tumors extending to the neck: surgical considerations based on imaging findings[J]. World Neurosurg, 2017,104:14-23.
[11] 邹林波, 贾禄, 张跃康,等. 应用改良的远外侧入路显微切除颈静脉孔区巨大哑铃型肿瘤[J]. 癌症, 2010, 29(2):223-227.
[12]吴波, 刘卫东, 陈隆益,等. 颈静脉孔区哑铃型肿瘤的显微手术治疗[J]. 中国临床神经外科杂志, 2013,18(05): 264-267
[13]李学记, 万经海, 吴跃煌,等. 颈静脉孔区颅内外沟通型神经鞘瘤的外科治疗[J]. 中国微侵袭神经外科杂志, 2011, 16(1): 22-25.
[14]Visocchi M, Signorelli F, Liao C, et al. Endoscopic endonasal approach for craniovertebral junction pathologies: myth and truth in clinical series and personal experience[J]. World Neurosurg, 2017, 101:122-129.
[15]张秋航, 郭宏川,王振霖, 等. 内镜经口入路颈静脉孔区神经鞘瘤切除术[J]. 中华耳鼻咽喉头颈外科杂志, 2012, 47(5):363-367.
[16]Zhang Q, Lv H, Wang Z, et al. Endoscopic transoral approach for extracranial hypoglossal schwannoma[J]. ORL, 2011, 73(5): 282-286.

基金

南京军区十一五一般课题基金资助项目(06MA16)


Accesses

Citation

Detail

段落导航
相关文章

/