摘要
目的通过CT测量了解乙状窦的优势引流、位置变异以及周围骨性结构的方法,以探讨桥小脑角和上、中斜坡区病变手术入路的选择。方法对54具成年人颅骨标本进行CT扫描,测量其眶耳线平面,并对比观察乙状窦的优势引流、位置的变异,乳突的气化程度、范围,颈静脉球窝的位置、大小,以及中耳、内耳门的结构。结果54具标本中乙状窦沟右侧大于左侧者45具(83.3%);左侧大于右侧者6具;双侧近似者3具。乙状窦沟前壁至外耳道后壁距离平均为13.5mm。颈静脉球窝于双侧眶耳线平面上的总出现率为37.0%(40/108)。结论头部CT测量可较为完整地了解乙状窦沟及其周围骨性结构,对桥小脑角和上、中斜坡区病变手术入路的选择具有参考价值。当一侧乙状窦前移时,上、中斜坡区中线的病变可考虑于非优势引流侧施行手术,而桥小脑角病变则可选择乙状窦后入路手术。
Objective To study the selection of surgical approaches for lesions at cerebellopontine angle(CPA)and upper or middle clivus(UMC)through demonstrating the dominant drainage and location variation of sigmoid sinus and its adjacent bony structures by CT scan.Methods Fifty-four adult cadaver skulls were scanned and measured at orbital meatus line(OML)to observe the dominant drainage and position variation of sigmoid sinus,aerification degree and range of mastoid,position and size of jugular glomus and structures of middle ear or internal auditory canal.Results Of the fifty-four skulls,45(83.3%)had larger sigmoid sinus sulcus on the right side than the left,6showed larger ones on the left;the other3were similar on both sides.The average distance between the anterior wall of sigmoid sinus sulcus and posterior wall of ex-ternal auditory meatus was13.5mm.The occurrence rate of jugular vein bulb at both side of OML plane was37.0%(40/108).Con clu sion Sigmoid sinus sulcus and its adjacent bony structures can be rather complete-ly presented by CT scanning,which is helpful to the selection of surgical approaches for CPA and UMC le-sions.In case of sigmoid sinus anteriorly deviated,operations for mid line UMC lesions will be performed on the side of non-dominant drainage,while for lesions at CPA the retrosigmoid approach is preferred.[
关键词
乙状窦沟
周围骨性结构
CT
参考值
颅窦
颈静脉球
Reference values Cranial sinuses Glomus jugulare Tomography,X-ray computed Anatomy ,regional
