【作者】 张瑞锋；

【导师】 徐国本；

【作者基本信息】 郑州大学 ， 神经外科， 2006， 硕士

【摘要】 本研究旨在了解桥小脑角的显微解剖；探讨枕下乙状窦后入路及乙状窦后-内耳道上入路的优缺点。本实验采用15例(30侧)干标本和10例(20侧)湿标本，按照枕下乙状窦后入路和乙状窦后-内耳道上入路的所涉及的解剖区域，解剖观测面神经、中间神经、小脑前下动脉及岩静脉等诸多结构，并对神经外科手术乙状窦后入路及乙状窦后。内耳道上入路作初步探讨，主要实验结果如下： 1．面神经桥小脑角池段长为11.13士1.35mm，内耳道段长为10.69±0.90mm。面神经在桥延沟的外端起自脑干，与其外侧的前庭蜗神经进入脑干处相距2.38+0.65mm，距外侧展神经6.62±0.41mm，距三叉神经7.59±1.08mm。由交汇角内前方沿岩骨探查32mm，即可发现面听神经。 2．中间神经单根束居多，共12侧，两根束6侧，三根束2侧。未见四根束。中间神经前庭部长为7.62±0.69mm，中间部长为10.05±1.12mm。 3．小脑前下动脉 小脑前下动脉(AICA)出现率为100％,20侧共23支，单干18侧，双干1侧，三干1侧，未见缺失。20支起自基底动脉(BA)下段，2支起自BA中段，1支起自BA上段。副小脑前下动脉共出现3支，主要分支有迷路动脉、回返穿通动脉、弓状下动脉。 4．10例(20侧)标本共有27支岩静脉，6侧中存在有2～3支岩静脉。岩静脉在脑桥小脑角内各属支的汇合点至岩上窦入口处的距离为3.46±1.87mm。岩静脉在注入岩上窦入口处的压扁外径为2.26±0.82mm。可在前庭蜗神经正上方71mm更多还原

【Abstract】 To explore the microdissection of the cerebellopontine angle(CPA) as well as to study the advantage and disadvantage of the retrosigmoid approach(RSA) and the retrosigmoid suprameatal approach (RSSMA), the relationship among the facial nerves, inter-medium nerves, anterior inferior cerebellar artery(AICA) and petrosal vein were studied, and two approaches particularly also were explored from fifteen dry skulls and ten wet skulls, along the approach of RSA and RSSMA. The results were as follows:1. The facial nerves, whose length of CPA was 11.13±1.35mm and the length of internal auditory canal was 10.69±0.90mm. From the brain stem at the lateral end of ponto medullary sulcas, the distance between the facial nerve, the vestibulocochlear nerve, the abducenst nerves, and the trigeminal nerve were 2.38±0.65mm, 6.62±0.41mm, 7.59±1.08mm. The facial nerves and vestibulocochlear nerve could be seen at the inner front part of 32 mm from the intersection endo-anterior.2. There were one-rootlet of the inter-medium nerves in twelve sides, two in six samples and three in two sides. No four-rootlet were found. The vestibular portion was 7.62±0.69mm long, the intermediate space was 10.05±1.12mm.3. The frequency of AICA was 100%. There were twenty-three in twenty CPAs, single stem in eighteen CPAs and duplicate stem in one CPAs, tristem in one CPA. There were twenty stems originated from the inferior segment of basal artery, two of which were from the intermediate piece and one from the superior segment. The appearing of Para-AICA was three. The main branch of the AICA was labyrinthine更多还原