额颞眶颧入路显微解剖学的研究

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1、【摘要】目的为额颞眶颧手术入路提供显微外科解剖学基础。方法10例经福尔马林固定的国人成人尸头共20侧，15例头颅干标本共30侧，对额颞眶颧手术入路相关解剖标志进行了详细地显微解剖、观察、拍摄、测量和统计。结果面神经额支与颧支、眶上孔或眶上切迹出入眶的眶上神经及血管均存在变异的可能，离断颧弓的断端间距约30mm，颅骨外板外缘至颧骨前后根夹角处距离约25mm，前后根交点与中颅窝底的夹角为-0.03±2.83（-5.0～4.0）°。结论额颞眶颧入路适用于起源于蝶骨嵴或眶内且向前颅窝延伸及颅内部分主要集中位

2、于中颅窝底的巨大颅眶沟通瘤;入路的手术空间和视角较理想，是眶尖区联合手术入路中复杂的手术类型之一，应根据手术需要酌情采用。　　关键词额颞眶颧手术入路颅底显微解剖　　Studyonthemicrosurgicalanatomyofthefrontotemporal-orbitozygomaticapproach　　YangJun，ZhangQinglin，YuChunjiang，etal.　　TheSecondHospital，AffiliatedtoShandongUniversity，Jinan2

3、50033　　【Abstract】ObjectiveTostudythemicrosurgicalanatomyofthefrontotemporal-orbitozygomaticapproachandprovideanatomicalbasisforoperativeapproach.Methods10cases（20sides）ofChineseadultcadaverheadsfixedby10%formalinand15cases（30sides）ofdryskullsampleswere

4、studied.Therelativeanatomicallandmarksofthefrontotemporal-orbitozygomaticapproachweredissectedundermicroscope，observed，photographed，measuredandanalyzed.ResultsThefrontalandzygomaticbranchesofthefacialnervesandthesupraorbitalnervesandvesselsviathesuprao

5、rbitalforamenorincisurehadvariations.Thespacingbetweenthebrokentipsofthebrokenzygomaticarchwasabout30mm.Thedistancefromtheouterborderoftheskulltotheintersectingpointoftheanteriorandtheposteriorrootofthezygomaticbonewasabout25mm.Theanglebetweentheinters

6、ectingpointoftheanteriorandtheposteriorrootandthemiddleskullbasewas0.03±2.83（-5.0～4.0）°.ConclusionTheFrontotemporal-orˉbitozygomaticapproachisapplicabletothegreatcranio-orbitaltumorswhichoriginatefromthesphenoidwingorwithintheorbit，extendtotheanteriors

7、kullfossa，andmainlylieinthemiddleskullfossa.Theoperativespaceandvisualangleofthisapproacharesatisfactory.However，thisapproachmightdamagethevariedstructuresandisoneofthemostcomplexoperationsamongthecombinedapproachesintheorbitalapexregion.Thisapproachsh

8、ouldbeusedwithdiscretionaccordingtotheoperativeneed.　　Keywordsfrontotemporal-orbitozygomaticoperativeapproachskullbasemicrosurgicalanatomy　　本文通过对头颅标本进行显微解剖，以求为额颞眶颧手术入路提供详细的相关显微解剖材料。　　1材料与方法　　1.1标本材料10例20侧经10%福尔马林充分固定的国人成人头颅湿标本，动脉系统灌注混有红