欢迎访问《解剖学报》官方网站！今天是
English
枕下极外侧入路应用解剖学探讨及手术体会
Applied anatomy of far lateral suboccipital approach and its clinical experience
目的 探讨枕下极外侧入路切除延颈交界区腹侧病变的效果，并对一些手术技巧加以讨论。 方法 在10例成人尸头上模拟枕下极外侧入路进行延颈交界区腹侧局部显微解剖探讨，观测延颈交界区有关结构。采用枕下极外侧入路对26例延颈交界区腹侧及腹外侧病变进行手术治疗。 结果 本组26例患者，9例痊愈，17例好转。14例肿瘤全切除，12例次全切除。全组无手术死亡。术后并发症包括面瘫2例，后组脑神经轻度麻痹1例，脑脊液漏1例。 结论 枕下极外侧入路可以满足延颈交界区腹侧及腹外侧病变手术野的显露，是切除该部位病变的一种有效的手术方法。
Objective To analyse the operative results of removing craniocervical junction region (CCJR),and its surgical techniques. Methods Micro-anatomy of craniocervical junction region was studied in 10 adult cadaver heads for simulation of far lateral suboccipital approach. The structure of the extension neck junction was observed. The far lateral suboccipital opproach was used on 26 cases with lesions surgery of the anterior or anterolateral CCJR. Results Of 26 patients, 9 patients were recovered and 17 patients improved. There were 14 cases of tumor resection, and 12 cases of subtotal resection. There was no operative mortality. Postopertive complications included facial paralysis in 2 cases, mild cranial nerve palsy in 1 case, and cerebrospinal fluid leakage in 1 case. Conclusion The far lateral suboccipital approach can extensively reveal the surgical field of the anterior and anterolaeral CCJR, and is an effective surgical resection of the lesion site.
［1］Rhoton AL. The foramen magnum ［J］.Neurosurgery, 2000, 47（Suppl 1）:S155-S193.
［2］Wu Q, Wang HD, Shin YS, et al. Brainstem Congestin due to dural ateriovenous fistula at the craniovervical junction［J］. J Korean Neurosurg Soe,2014,55(3):152-155.
［3］Liu J,Chen ZhB,Wang JM,et al.Microsurgery through far-lateral suboccipital approach for meningiomas located in the ventral and ventrolateral regions of the foramen magnum(report of 11 cases)［J］.Chinese Journal of Clinical Neurosurgery, 2012, 17(6):331-333. (in Chinese)
刘佳,陈治标,王军民,等.远外侧入路切除枕骨大孔区腹侧及腹外侧脑膜瘤的显微手术探讨(附11例报告)［J］.中国临床神经外科杂志, 2012,17(6):331-333.
［4］Chen Y,Chang HX,Wang W,et al. A method of spatial coodinates conversion in the digital human brain［J］. Acta Anatomica Sinica,2011,42(6):859-961.(in Chinese)
陈禹,常洪贤,王伟,等.数字人脑空间坐标转换方法［J］.解剖学报,2011,42(6):859-961.
［5］Li QY,Zhang ShX,Wang PA,et al. Construction of digitized anatomical model and visualization of human cerebrum［J］.Acta Anatomica Sinica,2005,36(6):638-641.(in Chinese)
李七渝,张绍祥,王平安,等.人体大脑数字化解剖模型的构建及可视化［J］.解剖学报,2005,36(6):638-641.
［6］Chen YF,Yi ZhQ,Bao ShD.Comparative study of bone resection of different positions and exposure extent via far lateral approach［J］. Chinese Journal of Minimally Invasive Neurosurgery, 2012,17(1):36-38.(in Chinese)
陈源锋,伊志强,鲍圣德.远外侧入路不同部位骨质切除与显露范围的对比研究［J］.中国微侵袭神经外科杂志, 2012,17(1):36-38.
［7］Abdel Aziz KM, Sanan A, Van Loveren HR, et al. Petroclival meningiomas: predictive parameters for transpetresal approaches［J］.Neurosurgery,2000, 47(1):139-150.
［8］Jackler RK, Sim DW, Gutin PH, et al. Systematic approach to intradural tumors ventral to the brainstem［J］. Am J Otol, 1995,16(1):39-51.
［9］Bian LG,Xu ZhB,Gao GZh,et al.The classification and microsurgery of magnum foramen tumor［J］. Chinese Journal of Neurosurgery, 2011,27(1):3-6.(in Chinese)
卞留贯,徐正保,高广忠,等.枕大孔区肿瘤的分型及手术入路选择［J］.中华神经外科杂志, 2011,27(1):3-6.
［10］Zhang JT,Wang ZhCh,Wu Zh,et al.Microneurosurgical treatment of the foramen magnum meningiomas［J］. Chinese Journal of Neurosurgery, 2000,16（3）:159-161.(in Chinese)张俊廷,王忠诚,吴震,等.枕骨大孔区脑膜瘤显微外科手术治疗［J］.中华神经外科杂志, 2000,16（3）:159-161.
［11］Zhao X, Yu RT, Li JS, et al. Clinical value of multi-slice 3-dimensional computed tomographic angiography in the preoperative assessment of meningioma［J］.Exp Ther Med, 2013, 6(2): 475-478.
［12］Russo VM, Graziano F, Quiroga M, et al. Minimally invasive supracondylar transtubercular (MIST) approach to the lower clivus［J］.World Neurosutg,2012,77(5-6):704-712.
［13］Liu Q,Zhao D,Xu H,et al.Microsurgery treatment of 25 tumors in medullocervical junction［J］. Chinese Journal of Neurosurgery, 2015,31(2):146-149. (in Chinese)
刘祺,赵冬,许晖,等.显微手术治疗25例延颈交界区肿瘤［J］.中华神经外科杂志, 2015,31(2):146-149.
石河子大学重大科技攻关计划项目“枕下极外侧入路延颈交界区显微解剖与临床应用
/
| 〈 |
|
〉 |
