基底动脉顶端相关手术入路的显微解剖研究

尹浩; 刘窗溪; 游潮; 朱磊; 谌鸿斌; 马骏; 韩国强; 高方友; 王超; 王曲

中国临床解剖学杂志 ›› 2013, Vol. 31 ›› Issue (1) : 10-12.

应用解剖

基底动脉顶端相关手术入路的显微解剖研究

尹浩¹，　刘窗溪¹，　游潮²，　朱磊³，　谌鸿斌¹，　马骏¹，　韩国强¹，　高方友¹，　王超¹，　王曲¹

作者信息 +

Study on microsurgical anatomy and related approaches of apex of basilar artery

YIN Hao¹, LIU Chuang-xi¹, YOU-Chao²，ZHU Lei³, CHEN Hong-bin¹, MA Jun¹, HAN Guo-qiang¹, GAO Fang-you¹, WANG Chao¹, WANG Qu¹

Author information +

文章历史 +

摘要

目的　研究基底动脉顶端的相关手术入路的显微解剖，评价其显露范围。方法　显微解剖10例（20侧）成人尸颅标本，通过翼点入路、颞下经小脑幕入路及乙状窦前入路三种方法显露基底动脉顶端，测量各自显露的距离和范围。显露范围由术者在显微镜下行主观评分。结果　翼点入路开颅骨窗到基底动脉顶端的最短距离为（63.85±2.54）mm，颞下经小脑幕入路到基底动脉顶端的距离为（66.58±　2.03）mm，乙状窦前入路到基底动脉顶端的距离为（66.01±1.41）mm，三种方法翼点入路显露距离最短，而显露范围无显著统计学差异。结论　翼点入路可使基底动脉顶端获得最佳显露。

Abstract

Objective　To study the neurosurgical microanatomy of approaches to the apex of the basilar artery to evaluate their exposure range.　Methods　10 cranial cadaver (20 sides) were researched in simulative neurosurgical approaches. Petrional approach, subtemporal transtentorial approach and presigmoid approach were used to observe the apex of basilar artery, and the exposure range of the three approaches was compared. Their exposure range was evaluated subjectively.　Results　The minimum exposure distance of the petrional approach, the subtemporal transtentorial approach, the presigmoid approach was (63.85±2.54)mm, (66.58±2.03)mm，(66.01±1.41)mm, respectively. Exposure distance of the petrional approach was shortest, there was no statistic difference in the subjective scorings of the three approaches.　Conclusion　The best exposure approach of the apex of basilar artery is the pterional approach.

导出引用

尹浩, 刘窗溪, 游潮, 朱磊, 谌鸿斌, 马骏, 韩国强, 高方友, 王超, 王曲. 基底动脉顶端相关手术入路的显微解剖研究[J]. 中国临床解剖学杂志. 2013, 31(1): 10-12

YIN Gao, LIU Chuang-Xi, LIU Chao, SHU Lei, CHEN Hong-Bin, MA Jun, HAN Guo-Jiang, GAO Fang-You, WANG Chao, WANG Qu. Study on microsurgical anatomy and related approaches of apex of basilar artery[J]. Chinese Journal of Clinical Anatomy. 2013, 31(1): 10-12

中图分类号： R323.1 R616.2

参考文献

[1] Sanai N, Tarapore P, Lee AC, et al. The current role of microsurgery for posterior circulation aneurysms: a selective approach in the endovascular era
[J]. Neurosurgery，2008，62(6):1236-1249.

[2] 许政, 张世明, 徐峰，等. 显微外科手术治疗颅内后循环动脉瘤(附21例分析)
[J]. 中国临床神经外科杂志, 2009,14(6)：327-329,336.

[3] 尹浩,朱磊,游潮,等.神经外科显微解剖标本保存方法的改良
[J].中华神经外科杂志,2011,27(9):969-970.

[4] 石祥恩，吴斌，王维兴，等.手术夹闭基底动脉顶分叉处动脉瘤
[J].中华神经外科杂志,2005,21(11): 650-653.

[5] Figueiredo EG, Deshmukh P, Zabramski JM, et al. The pterional- transsylvian approach: an analytical study
[J]. Neurosurgery, 2006, 59(4 Suppl 2):ONS263-2699.

[6] Coert BA, Chang SD, Do HM, et al. Surgical and endovascular management of symptomatic posterior circulation fusiform aneurysms
[J]. J Neurosurg, 2007, 106(5):855-865.

[7] Hernesniemi J, Ishii K, Karatas A, et al. Surgical technique to retract the tentorial edge during subtemporal approach: technical note
[J]. Neurosurgery, 2005, 57(4 Suppl): E408.

[8] 周毅,敖祥生,黄星,等.颞下锁孔入路手术治疗基底动脉顶端动脉瘤
[J].中国临床神经外科杂志,2011,16(5):268-269.

[9] 许海洋,杨钟熙,徐保锋,等. 岩斜坡区脑膜瘤的手术治疗
[J].中华神经外科杂志,2011,27(9):914-916.

[10]Hamel W, Grzyska U, Westphal M, et al. Surgical treatment of a basilar perforator aneurysm not accessible to endovascular treatment
[J]. Acta Neurochir (Wien), 2005,147(12):1283-1286.