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目的研究Meckel腔及毗邻结构的显微外科解剖关系,为临床手术治疗相关疾病提供解剖学依据。方法成人尸头标本10例(20侧),采用手术显微镜观察Meckel腔及毗邻结构。结果Meckel腔是颅后窝向颅中窝后内侧突入的硬脑膜凹陷,内有三叉神经运动根和感觉根、三叉神经节及三叉神经池,腔前后长(14.53±0.98)mm,内外宽(15.24±1.29)mm,上下厚(4.95±0.54)mm。三叉神经孔至Dorello管开口(9.25±1.14)mm,至内耳道开口(15.30±1.14)mm。Meckel腔内侧壁为各壁中比较薄的,内侧壁后部与颞骨岩尖部岩蝶韧带相贴,毗邻Dorell管;下壁前方隔岩舌韧带与颈内动脉破裂孔段相邻。结论 Meckel腔内侧壁的硬膜脑膜层较为菲薄,并直接与海绵窦静脉腔隙相邻,可能是肿瘤侵入海绵窦的薄弱点之一。岩蝶韧带和岩舌韧带可以作为前部经岩手术识别展神经和颈内动脉破裂孔段的解剖结构。
Objective To study the microsurgical anatomy of Meckel’s cavity and adjacent structures and to provide anatomic evidences for clinical surgery-related diseases. Methods Ten adult cadaver heads (20 sides) were enrolled in this study. The Meckel cavities and the adjacent structures were observed with a surgical microscope. Results The Meckel cavity was the posterior fossa recess of posterior fossa and posterior fossa of medial fossa. The medial and lateral sensory roots, the trigeminal ganglion and the trigeminal nerve pool were present in the Meckel cavity. The length of anterior and posterior chambers was (14.53 ± 0.98) mm, 15.24 ± 1.29) mm, thicker (4.95 ± 0.54) mm. The trigeminal nerve hole was opened to the Dorello tube (9.25 ± 1.14) mm and to the inner ear canal opening (15.30 ± 1.14) mm. The inner wall of Meckel is relatively thin in each wall, and the posterior wall of the medial wall is attached to the petrosal ligament of the temporal bone rock, adjacent to the Dorell canal. The anterior petrous ligament in the anterior wall of the inferior wall is adjacent to the ruptured hole of the internal carotid artery. Conclusion The dural mesenteric layer of Meckel cavity is relatively meager and directly adjacent to the cavernous sinus vena cava, which may be one of the weak points of invasion of cavernous sinus. The lumbar ligament and the ligament of the tongue can be used as the anterior petrous surgery to identify the anatomical structures of the anterior and internal carotid arteries.