摘要目的 探讨在硬膜下颞下岩前入路中精准定位Kawase三角区范围的方法.方法在14具干性颅骨上标记颅底内表面弓状隆起最高点(A)、岩骨嵴外侧缘-横窦前缘交汇点(J)、岩尖(P)、岩浅大神经沟最外侧缘点(B)、棘孔最外侧缘点(C)、卵圆孔最外侧缘点(D)、三叉神经压迹最外侧缘点(E)和破裂孔的最外侧缘点(F).以J点为参照点,测量JA、JB、JC、JD、JE、JF的距离;以J点与P点之间的连线(JP)作为基线,测量JA、JB、JC、JD、JE、JF连线与基线形成的角度.结果左侧、右侧颅骨JA、JB、JC、JD、JE、JF的距离差异均无统计学意义(P>0.05);左侧、右侧颅骨JA、JB、JC、JD、JE、JF连线与基线JP形成的角度差异均无统计学意义(P>0.05).结论以J点为参照点,以JP为基线,可以精准定位硬膜下颞下岩前入路中相关骨性结构,确定Kawase三角区范围,实现快速、精准、安全磨除岩前骨质,显露岩斜区.

abstractsObjective To explore the accurate positioning of Kawase triangle area via intradural anterior subtemporal transpetrosal approach. Methods On 14 dry skulls, the highest point of arcuate eminence (A), the junction of lateral margin of petrous ridge and anterior margin of transverse sinus (J), the petrous apex (P), the outermost point of sulcus nervi petrosi superficialis majoris (B), the outermost point of foramen spinosum (C), the outermost point of foramen ovale (D), the outermost point of trigeminal notch (E), and the outermost point of foramen lacerum (F) were marked. The distances of JA, JB, JC, JD, JE and JF were measured using point J as reference point. Using the line (JP) between point J and point P as the baseline, the angles of baseline with JA, JB, JC, JD, JE, and JF were measured. Results There were no significant differences in the distances of JA, JB, JC, JD, JE and JF between the left and right sides (P>0.05). There were no significant differences in the angles of the baseline with JA, JB, JC, JD, JE, and JF between left and right sides (P>0.05). Conclusion Using point J and the baseline JP as referent indexes, bony structures can be precisely located via intradural anterior subtemporal transpetrosal approach to orientate the Kawase triangle area; this method can insure rapid, accurate and safe drilling of anterior petrosal bone and exposing of petroclival region.