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目的探讨颅底手术中颈内动脉(ICA)定位的解剖学标志。方法将20例40侧新鲜成人尸头的颞骨制成标本,连续切片后嗜伊红染色,在显微镜下观察、测量,统计岩段ICA管垂直段和水平段的平均最大直径I、CA膝部与相邻重要结构耳蜗的最短距离和平均最短距离;计算ICA管裂开的出现率。结果在岩骨,ICA管水平段居于耳蜗的前内侧,ICA管垂直段位于鼓室的下方,ICA膝部居于耳蜗的内侧;岩段ICA管垂直段的平均最大直径为(7.92±0.96)mm,水平段的平均最大直径为(5.96±0.90)mm;膝部与相邻结构耳蜗的最短距离为0.37mm和平均最短距离(2.94±0.91)mm;岩段ICA管裂开的出现率15%。结论经耳侧颅底手术、经耳前(后)-颞下窝手术入路中,可通过定位耳蜗来定位ICA,避免ICA的损伤;岩段ICA管裂开的出现率较高,增加了手术的风险。
Objective To investigate the anatomical landmarks of internal carotid artery (ICA) in skull base surgery. Methods 20 cases of 40 adult fresh cadaver heads were made into temporal bone. The sections were stained with eosin. The average maximum diameters of vertical section and horizontal section of ICA tube were measured and observed under a microscope. And the adjacent important structure of the shortest cochlear distance and the shortest average distance; calculated ICA tube rupture incidence. Results In the petrous bone, the horizontal section of the ICA tube was located in the anteromedial side of the cochlea. The vertical section of the ICA tube was located below the tympanic cavity and the ICA knee was located inside the cochlea. The average vertical diameter of the vertical section of the ICA tube was (7.92 ± 0.96) mm, The average maximum diameter of the horizontal section was (5.96 ± 0.90) mm. The shortest distance between the knee and adjacent cochlea was 0.37 mm and the shortest average distance was 2.94 ± 0.91 mm. The incidence of ICA tube rupture in the rock segment was 15%. CONCLUSIONS: Intracranial placement of the cochlea through the ear and skull base surgery can locate the ICA and avoid the ICA injury. The incidence of ICA tube dehiscence in the rock segment is high, increasing Risk of surgery.