枕下乙状窦后入路微创显露颈静脉孔区的虚拟现实解剖研究.docVIP

枕下乙状窦后入路微创显露颈静脉孔区的虚拟现实解剖研究 汤 可，周敬安，赵亚群，周 青，刘 策 (100091 北京，解放军第309医院神经外科) ［提要］ 目的 在构建虚拟现实解剖模型基础上探讨枕下乙状窦后入路微创显露颈静脉孔区的显微解剖特征。 方法 15例尸体头颅行头颅CT和MRI扫描，影像数据输入虚拟现实系统构建颈静脉孔区三维解剖模型，在颅盖和颅底中选择骨性标志点设计枕下乙状窦后入路的不同微创路径，观察测量和比较伴随微创手术路径改变后解剖结构显露情况。结果模拟枕下乙状窦后入路显露的路径均由横窦下方穿过，路径中清晰显示所包含的神经、血管等解剖结构的空间层叠顺序，均不包含椎动脉和小脑后下动脉。不包含后组颅神经小脑前下动脉和测量和比较 of suboccipito-retrosigmoidal approach for minimally invasive exposure of jugular foramen region utilizing virtual reality technology Tang Ke, Zhou Jingan, Zhao Yaqun, Zhou Qing, Liu Ce (Department of Neurosurgery, The 309th Hospital of PLA, Beijing 100091, China) [Abstract] Objective To discuss microanatomy features of jugular foramen region in suboccipito-retrosigmoidal minimally invasive approach based on virtual reality image model. Methods CT and MRI scans were performed for fifteen adult cadaver heads, and then the image data was inputted into Vitrea virtual reality system to establish three-dimensional anatomy model of jugular foramen region. Different minimally invasive suboccipito-retrosigmoidal approaches were simulated by selecting osseous landmark points on the calvaria and skull base. Anatomic exposures in surgical trajectory following alternation of minimally invasive approach were observed, measured and compared. Results Routes simulating suboccipito-retrosigmoidal approach for exposure of jugular foramen region passed under the inferior edge of transverse sinus. Spatial sequence of nerves and vessels in the route was displayed clearly. Vertebral artery and posterior inferior cerebellar artery did not show in the route. Lower cranial nerves did not show in route a. Facial-acoustic nerve complex did not show in route b. Three cases of route b did not involve anterior inferior cerebellar artery. Facial-acoustic nerve complex, anterior inferior cerebellar artery, and lower cranial nerves did not show in route c. Measurement and comparative analysis showed that: the volume of route and cerebella involved in route, route b route a rou