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目的探讨经上颌骨翻转入路切除颅底沟通肿瘤可行性及其显微解剖学关系。方法应用显微外科解剖学技术,对经甲醛固定、动静脉血管内分别灌注红、蓝乳胶的10具(20侧)成人尸头标本,模拟手术入路逐层解剖。观察手术径路中颞下窝、翼腭窝、蝶筛区、前颅底、中颅底等区域的显露情况及重要解剖结构之间的关系。结果翼突、中鼻甲、上颌神经是经上颌骨翻转手术入路切除颅底沟通肿瘤的三个重要解剖标志,此入路对颞下窝、翼腭窝、前、中颅底、斜坡区显露满意,有充足的手术操作空间切除颅底沟通肿瘤。结论上颌骨翻转入路切除颅底沟通肿瘤手术可行,从颅外暴露颅底,对脑组织的牵拉损伤小。熟悉此入路的显微解剖学关系,对开展此手术入路切除颅底沟通肿瘤具有指导意义。
Objective To investigate the feasibility and anatomy of the tumors of the skull base by maxillary inversion approach. Methods Microsurgical anatomic techniques were used to simulate the surgical approach of 10 adult (20 sides) adult cadaver heads, which were fixed with formaldehyde and were perfused with red and blue latex respectively. To observe the surgical path in the temporal fossa, pterygopalatine fossa, butterfly sieve area, anterior skull base, the skull base and other areas of exposure and the relationship between the important anatomical structures. Results The pterygoid, middle turbinate and maxillary nerve were the three important anatomical landmarks for resection of tumors of the basilar skull through the approach of maxillary inversion surgery. The approach revealed the infratemporal fossa, pterygopalatine fossa, anterior, middle skull base and slopes Satisfactory, there is sufficient space for surgical resection of skull base tumor. Conclusion Maxillary tumour approach resection of the skull base tumor surgery feasible from the extracranial exposure of the skull base, the traction of the brain injury is small. Familiar with the approach of the micro-anatomical relationship, to carry out this surgical approach to remove the skull base tumor has guiding significance.