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目的对额颞经颧弓-颞下手术入路进行显微外科解剖学研究,为手术入路提供解剖学基础。方法利用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,对额颞经颧弓-颞下手术人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存在变异的可能,离断颧弓的断端间距约30mm,颅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)°。与保留颧弓相比,离断颧弓后的骨窗下缘至颞底可缩短15mm左右的距离,与干标本测量颧弓宽度的数据14．76mm相当。海绵窦中段的截面、视神经管和眶上裂的解剖关系相对固定。结论额颞经颧弓-颞下手术入路适用于海绵窦-眶尖区病变,其手术空间和视角非常理想,应根据手术需要酌情采用。
Objective To study the microsurgical anatomy of the frontotemporal zygomatic arch-infratemporal approach to provide an anatomical basis for surgical approach. Methods 10 adult cadavers with 20 cadaveric heads were fixed in formalin and 30 cranial cadavers were used in 30 cases. The anatomical landmarks of the frontotemporal - zygomatic arch - infratemporal surgery were dissected in detail. , Observation, shooting, measurement and statistics. Results The facial nerve branch and zygomatic branch may exist variations. The interval between the ends of the zygomatic arch is about 30 mm. The distance between the outer edge of cranial board and the anterior and posterior root of zygomatic arch is about 25 mm. The included angle between the anterior and posterior roots and the base of middle cranial fossa -0.03 ± 2.83 (-5.0-4.0) °. Compared with preserving the zygomatic arch, the distance from the lower edge of the bone window to the temporal base after the zygomatic arch was cut off could be shortened by about 15mm, which was equivalent to the data of the zygomatic arch width measured by the stem specimen of 14.76mm. Section of the middle of the cavernous sinus, optic canal and superior orbital fissure anatomical relationship is relatively fixed. Conclusions Frontal temporal zygomatic arch-infratemporal approach is suitable for cavernous sinus-orbital apex disease. Its operative space and visual angle are ideal and should be used according to the needs of operation.