【摘要】：目的：設(shè)計(jì)和提出神經(jīng)導(dǎo)航下顳下巖前經(jīng)小腦天幕鎖孔入路手術(shù)的治療方案，通過(guò)尸頭模擬操作，研究顳下巖前小腦天幕鎖孔入路在神經(jīng)導(dǎo)航輔助下視野和操作變化，對(duì)該入路的可行性，科學(xué)性進(jìn)行評(píng)估，并進(jìn)行臨床應(yīng)用研究。 方法：通過(guò)神經(jīng)導(dǎo)航輔助下顳下巖前經(jīng)小腦天幕鎖孔入路暴露鞍旁海綿竇以及巖斜區(qū)顯微解剖結(jié)構(gòu)，，實(shí)時(shí)導(dǎo)航定位巖骨內(nèi)部重要結(jié)構(gòu)，如耳蝸，頸內(nèi)動(dòng)脈巖骨段，內(nèi)聽(tīng)道，耳蝸，半規(guī)管等，實(shí)現(xiàn)最大安全系數(shù)和最大范圍的磨除巖尖，暴露鞍后區(qū)和上，中斜坡區(qū)等結(jié)構(gòu)。對(duì)其暴露范圍和實(shí)用性進(jìn)行評(píng)估和研究。 結(jié)果：顳下巖前經(jīng)小腦天幕鎖孔入路可完全暴露鞍旁區(qū)，術(shù)中通過(guò)海綿竇外側(cè)壁的手術(shù)三角區(qū)可對(duì)累及海綿竇內(nèi)外病灶施行直視下手術(shù)切除，通過(guò)Meckels腔的打開(kāi)，可切除侵犯Meckels腔并向中后顱窩生長(zhǎng)的各種類(lèi)型腫瘤，同時(shí)在神經(jīng)導(dǎo)航的輔助下，可安全磨除巖尖骨質(zhì)，最大范圍的暴露橋小腦角（CPA），斜坡鞍后區(qū)、上、中斜坡區(qū)等結(jié)構(gòu)。 結(jié)論：在神經(jīng)導(dǎo)航下顳下巖前經(jīng)小腦幕入路，科學(xué)、安全、微創(chuàng)、便捷、實(shí)用，能最大程度暴露蝶巖斜區(qū)病變的入路。
[Abstract]:Objective: to design and propose a method for the treatment of anterior subtemporal keyhole approach via cerebellar tentorium keyhole under neuronavigation, and to study the changes of visual field and operation of anterior temporal cerebellar tentorium keyhole approach under neuronavigation by simulated cadaveric head operation. The feasibility of the approach, scientific evaluation, and clinical application research. Methods: the microanatomical structures of the parasellar cavernous sinus and the petroclival region were exposed through the anterior inferior temporal subtemporal keyhole approach assisted by neuronavigation, and the important structures of the petrosal bone, such as cochlea, internal carotid artery, petrosal bone, internal auditory canal, were detected by real-time navigation. Cochlea, semicircular canal, etc., to achieve the maximum safety factor and the maximum range of petrous tip, exposed the posterior saddle region, upper and middle slope area and other structures. The exposure scope and practicability were evaluated and studied. Results: the parasellar area could be completely exposed by the anterior subtemporal petrosal approach through the keyhole approach of the cerebellum tentorium. The lesions inside and outside the cavernous sinus could be removed directly by the operation triangle area of the lateral wall of the cavernous sinus during the operation, and the Meckels cavity could be opened. Various types of tumors invading the Meckels cavity and growing into the middle and posterior cranial fossa can be excised. At the same time with the aid of neuronavigation the petrous apical bone and the maximum exposure cerebellopontine angle (CPA), posterior Clivus region superior and middle Clivus region can be safely removed. Conclusion: it is scientific, safe, minimally invasive, convenient and practical to approach anterior inferior temporal petroclima under neuronavigation, which can expose the lesions of the diagonal region of sphenolith to the maximum extent.
【學(xué)位授予單位】：蘇州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類(lèi)號(hào)】：R739.41

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