颈丛交感神经作为海绵窦内视神经的标志:尸体解剖研究与手术考虑。

IF 1.7 4区 医学 Q3 CLINICAL NEUROLOGY
I-Sorn Phoominaonin, Andres Felipe Vargas Rosales, Garret W Choby, Eric W Wang, Georgios A Zenonos, Carl H Snyderman, Paul A Gardner
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引用次数: 0

摘要

背景和目的:在内窥镜经腔镜手术中,外展神经(CN VI)很容易受到损伤。在这项研究中,作者旨在建立手术解剖地标,并探索颈内动脉(ICA)周围的交感神经(SN)与海绵窦(CS)内的 CN VI 之间的关系:方法:在 15 具尸体标本中研究了交感神经(SN)和 CN VI 之间的关系和模式。方法:研究 15 具尸体标本中的 SN 和 CN VI 之间的关系和模式,并展示术中解剖标志的实例:结果:ICA周围有SN进入CN VI,分为上升SN和附属交感支。升支交感神经分为 3 种类型:(1) I 型只有一条升支交感神经。I 型有 2 个亚型(IA 型[17/30,56.7%]定义为单支升支进入 CN VI,IB 型[4/30,13.3%]定义为单支升支在并入 CN VI 或 CS 侧壁前有末端分叉);(2)II 型(7/30,23.(3)Ⅲ型(2/30,6.7%)定义为有 3 个上升支进入 CN VI 和 CS 侧壁。6/30侧(20%)SN的附属分支由来自后属或水平ICA的交感神经分支定义:作者提出了内窥镜鼻内镜手术中CS内部瓣旁ICA SN和CN VI之间关系的分类方法。升支SN和CN VI在CS内的一致关系为鼻内镜手术接近CS提供了可靠的解剖标志。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Carotid Plexus Sympathetic Nerves as a Landmark for the Abducens Nerve Within the Cavernous Sinus During Endoscopic Endonasal Surgery: Cadaveric Anatomic Study and Surgical Consideration.

Background and objectives: The abducens nerve (CN VI) is vulnerable to injury during endoscopic endonasal transcavernous surgery. In this study, the authors aimed to develop the surgical anatomic landmark and explore the relationship between the sympathetic nerves (SNs) around the internal carotid artery (ICA) and CN VI within the cavernous sinus (CS).

Methods: The relationship and patterns between the SNs and CN VI were investigated in 15 cadaveric specimens. The intraoperative examples of anatomic landmark were presented.

Results: There were SNs around the ICA running into the CN VI, classified into ascending SNs and accessory sympathetic branches. The ascending SNs were divided into 3 types: (1) Type I had a single ascending SN. There were 2 subtypes of Type I (Type IA [17/30, 56.7%] was defined as a single ascending branch that ran into the CN VI, and Type IB [4/30, 13.3%] was defined as a single ascending branch with a terminal bifurcation before merging into the CN VI or lateral CS wall), (2) Type II (7/30, 23.3%) was defined as 2 ascending branches that ran into the CN VI and the lateral CS wall, and (3) Type III (2/30, 6.7%) was defined as 3 ascending branches that ran into the CN VIs and the lateral wall of the CS. The accessory branches of the SNs were defined by sympathetic branches from the posterior genu or horizontal ICA and found in 6/30 sides (20%).

Conclusion: The authors propose a classification of the relationship between paraclival ICA SNs and the CN VI within the CS, as approached during endoscopic endonasal surgery. The consistent relationship of the ascending SN and CN VI within the CS provides a reliable anatomic landmark during the endonasal approach to the CS.

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来源期刊
Operative Neurosurgery
Operative Neurosurgery Medicine-Neurology (clinical)
CiteScore
3.10
自引率
13.00%
发文量
530
期刊介绍: Operative Neurosurgery is a bi-monthly, unique publication focusing exclusively on surgical technique and devices, providing practical, skill-enhancing guidance to its readers. Complementing the clinical and research studies published in Neurosurgery, Operative Neurosurgery brings the reader technical material that highlights operative procedures, anatomy, instrumentation, devices, and technology. Operative Neurosurgery is the practical resource for cutting-edge material that brings the surgeon the most up to date literature on operative practice and technique
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