解剖学报 ›› 2020, Vol. 51 ›› Issue (5): 677-681.doi: 10.16098/j.issn.0529-1356.2020.05.007

• 解剖学与耳鼻喉科学 • 上一篇    下一篇

基于解剖平面的内镜经口入路咽旁段颈内动脉定位方法及临床应用

王振霖* 张秋航* 刘俊其 齐岩 张思远 侯思源   

  1. 首都医科大学宣武医院耳鼻咽喉头颈外科,颅底外科中心,北京 100053
  • 收稿日期:2020-04-06 修回日期:2020-05-04 出版日期:2020-10-06 发布日期:2020-10-06
  • 通讯作者: 王振霖;张秋航 E-mail:wzl1812@163.com

A transoral endoscopic approach to locate the parapharyngeal segment of the internal carotid artery

WANG Zhen-lin* ZHANG Qiu-hang* LIU Jun-qi QI Yan ZHANG Si-yuan HOU Si-yuan#br#   

  1. Department of Otorhinolaryngology Head and Neck Surgery, Skull Base Center, Xuanwu Hospital, Capital Medical University, Beijing 100053,China
  • Received:2020-04-06 Revised:2020-05-04 Online:2020-10-06 Published:2020-10-06
  • Contact: WANG Zhen-lin;ZHANG Qiu-hang E-mail:wzl1812@163.com

摘要:

目的 探讨内镜经口入路中咽旁段颈内动脉(ICA)的定位方法。  方法 对4例新鲜尸头标本进行内镜经口入路至颞下窝/咽旁间隙解剖。在37例该区域肿瘤手术中应用基于解剖平面的ICA定位方法评价定位效果。 结果 在全部标本中均可清晰分辨咽缩肌层、头长肌前筋膜层和茎突咽筋膜层等解剖平面,后两者交界处稍外侧可作为定位咽旁段ICA的内侧入路标志。采用该方法在手术中实现了93.10% 的ICA准确定位成功。  结论 基于解剖平面的咽旁段ICA定位方法解决了内镜经口入路手术的难题,方法较为可靠。

关键词: 颞下窝, 颈内动脉, 经口, 解剖学, 内镜,

Abstract:

Objective To establish an anatomically-based method  for locating the parapharyngeal segment of the internal carotid artery (ICA) via transoral endoscopy.   Methods Applied anatomic study was performed in 4 fresh adult cadaver heads (8 sides) via transoral endoscopy to explore the infratemporal fossa/parapharyngeal space. The localization method  based on anatomic plane was subsequently used in 37 cases of tumor surgery in this area, with the operational accuracy evaluated.   Results Following dissection of the layers of pharyngeal constrictor, anterio fascia of the longus capitis and stylopharyngeal fascia, the junction of the latter two was identified as a potential landmark to locate the parapharyngeal ICA in surgery. Following practice on the patients, a success rate of 93.10% was achieved by using this method  for ICA localization.   Conclusion The parapharyngeal ICA localization method  based on anatomic plane is clinically reliabie.

Key words: Infratemporal fossa, Internal carotid artery, Transoral, Anatomy, Endoscopy, Human

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