摘要
目的:为颅底显微外科提供展神经的解剖学资料,同时探讨其脆弱性的解剖基础。方法:观测15例(30侧)成人头颅标本展神经的位置、行径及毗邻,并对其分段测量。结果:①展神经颅内段可分为5段:脑池段(15.01±2.56)mm,岩斜段(6.38±1.78)mm,动脉后段(2.81±1.32)mm,跨动脉段(5.76±0.84)mm,动脉前下段(15.63±2.03)mm;②展神经颅内段在行程中形成3个转角,分别位于脑膜入口处、岩尖及颈内动脉(ICA)的外侧面;③斜坡内动脉、斜坡外动脉、小脑幕动脉、垂体下动脉及下干的前外侧支与展神经关系密切;④展神经三角:由岩蝶韧带、三叉神经囊内侧面及ICA后外侧面围成,展神经动脉后段经过此三角;⑤在ICA外侧面有交感神经以锐角加入展神经。结论:①展神经行程中的3个转角,以及与血管、神经、韧带、骨等复杂的解剖关系,使其脆弱而易于损伤;②在斜坡区、颞骨岩部和海绵窦手术时必须予以识别和保护。
Objective： To provide anatomic data for skull base microsurgery, and explore anatomic factors that contribute to the vulnerability of abducens nerve. Methods： Location, course and surrounding structures of abducens nerve were studied on 30 specimens obtained from 15 cadaver heads, at the same time subsectional measurement were made. Results： ① The abducens nerve can be divided into five segments： the cistemal segment with the length of （15.01 ±2.56）mm, the petroclival segment （6.38±1.78）mm, the posterior segment of ICA （2.81 ±1.32）mm, the superior segment of ICA （5.76±0.84）mm,and the anteroinferior segment of ICA （15.63±2.03）mm. ② Abducens nerve exhibited three different angulations during its course from the external side of brainstem to the superior orbital fissure, located at the dural entrance porus, the petrous apex and the lateral wall of the cavernous segment of ICA respectively. ③ Abducens nerve intimately related with the medial artery of clivus, the lateral artery of clivus, the tentorial marginal artery, the inferior hypophyseal artery and the anterolateral branch of its inferolateral trunk.④ Triangle of abducens nerve was formed by the petrosphenoidal ligament, the medial wall of Meckers cave and the posterolateral wall of ICA, and abducens nerve passed through this triangle. ⑤ Sympathetic fibres joined the abducens nerve on the lateral wall of internal carotid artery at an acute angle. Conclusion： Abducens nerve is easy to be injured for the forming of three different angulations during its courses, and its complicated anatomic relationship with blood vessel, nerves, ligaments and bones. It should be identified and protected carefully when performed operations in petrous and clivus regions and cavernous sinus.
出处
《中国临床解剖学杂志》
CSCD
北大核心
2007年第2期125-128,共4页
Chinese Journal of Clinical Anatomy
