经眶下裂至圆孔穿刺入路的应用解剖.pdf

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1、中华解剖与临床杂志2014年2月第19卷第1期ChinJAnatClin。February2014．Vo1．19．Nn1·37·断层解剖与影像经眶下裂至圆孔穿刺人路的应用解剖孙鑫朱亚文林建陶高见【摘要】目的为经眶一圆孔入路行射频热凝术治疗三叉神经第二支三叉神经痛提供解剖测量数据。方法对80个成人头骨经眶一圆孔穿刺入路及相关结构进行了测量与观察，对20个头颅软标本进行在CT引导下模拟操作与观察。结果在160侧颅骨中，成功穿进圆孔者为122侧，占76．25％；穿刺点位于眶下缘外眦的内侧(0．41±0．11)cm；经穿刺点至圆孔外口的距离为(4．454-o．18)cm，至圆孔内

2、口前缘的距离为(4．99±0．17)cm，至颈动脉沟外侧缘距离为(5．52±0．35)cm。头颅软标本模拟操作穿刺安全有效深度为(5．38±0．25)cm；穿刺针进入圆孔时针与正中矢状面角度为32．2。±2．3。，与冠状面角度为57．2。±2．5。；穿刺针进入眶上裂后端时针与正中矢状面角度为26．0。±1．5。，与冠状面角度为64．5。±1．6。。结论根据解剖测量数据，在CT引导下经眶下裂至圆孔穿刺法行临床治疗第二支三叉神经痛安全可靠，疗效确切。【关键词】眶下裂；圆孔；颈动脉沟；上颌神经；CT引导Appliedanatomyofpuncturethroughinferio

3、rorbitalfissureandforamenrotundumapporachSunXin，ZhuYawen，LinJian，TaoC．aojian．DepartmentofAnatomy，MedicalSchoolofNangUniversity，№ng21008，ChinaCorrespondingauthor：ZhuYawen，Email：zhuyawerd394@163．con【Abstract】ObjectiveToprovideanatomicaldataofradiofrequencythermocoagulationinthetreatmentofV2

4、trigeminalneuralgiathroughinferiororbitalfissureandforamenrotundumapproach．MethodsTheapproachthroughinferiororbitalfissureandforamenrotundumaswellasitsneighboringstructureswereobservedandmeasuredon160sidesof80adultcraniumand20adultcadavers．ResultsIn160casesofaduhcranium．thenumberofsuccess

5、intoforamenrotundumwas122(76．25％)．Thedistanceofthepuncturepointtothelateralofinfraorbitalmarginwas(0．41±0．11)cm．rhedistancefromthepuncturepointtotheouteredgeof山eforamenrotundumwas(4．45±0．18)cm；thedistancefromthepuncturepointtotheinnerfrontedgeoftheforamenrotundumwas(4．99±0．17)cm；thedistan

6、cefromthepuncturepointtothelateralofCarotidarterygroovewas(5．52±0．35)cm．11hesafeandeffectivedepthintheadultcadaverswas(5．38±0．25)cm；theanglebetweenneedleandmediansagittalplanewas32．2。±2．3。andbetweenneedleandcoronalplanewas57．2。±2．5。whenitenteredtheforamenrotundum：theanglebetweenneedleandm

7、ediansagittalplanewas26．0。±1．5。andbetweenneedleandcoronalplanewas64．5。±1．6。whenitenteredtheendofthesuperiororbitalfissure．ConclusionsAccordingtotheanatomicaldata，CTguidedradiofrequencythermocoagulationintreatmentofV2trigeminalneuralgiathroughinferiororbitalfissurean