乙状窦后入路两种骨性标志定位与静脉窦关系的比较

摘要

目的 探讨乙状窦后入路两种骨性标志(乳突根部后缘及星点)定位与静脉窦的准确性比较.方法 30例患者随机分成A组(星点)和B组(乳突根部后缘),分别测量关键孔中心与横窦下缘(垂直距离)和乙状窦内侧缘的距离(水平距离),比较两组的水平及垂直距离.结果 B组患者关键孔与横窦之间平均垂直距离为(4.6±1.2)mm,明显小于A组的(8.3±2.7)mm,差异有统计学意义(P<0.05).同样,B组患者的水平距离[(2.8±1.1)mm]亦明显小于A组[(5.6±2.1)mm],差异有统计学意义(P<0.005).结论 乳突根部后缘比星点骨性定位关键孔准确,对乙状窦后入路横窦及乙状窦交角暴露更具指导意义,对临床手术过程有一定的参考价值.%Objective To explore the accuracy between the two kinds of bone landmarks(mastoid root trailing edge and asterion)and venous sinus relationship in retrosigmoid approach.Methods 30 cases randomly divided into group A (asterion) and group B (mastoid root trailing edge),measured the key hole center to the edge of the transverse sinus distance (vertical distance) and the sigmoid sinus inside edge distance (horizontal distance) ,and compared horizontal and vertical distance of two groups respectively.Results In group B,the average vertical distance between the key hole and the transverse sinus was (4.6±1.2 mm),significantly less than group A (8.3±2.7 mm),the difference was statistically significant (P<0.05),meanwhile,the average horizontal distance (2.8±1.1 mm) in group B was much shorter than in group A (5.6±2.1),the difference was statistically significant (P<0.005).Conclusion Osseous key hole accurate position in mastoid root trailing edge (group B) is better than asterion (group A).It has certain guiding significance and reference value to expose transverse and sigmoid sinus transition in retrosigmoid approach.