| 经口咽下颌骨劈开中上颈椎前路手术的解剖研究与临床应用 |
Alternative Title | The anatomical study and clinical applications of the transoral anterior approach with mandibulotomy for upper and middle cervical
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| 王克平 |
Thesis Advisor | 周海宇
; 汪静
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| 2015-05-22
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Degree Grantor | 兰州大学
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Place of Conferral | 兰州
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Degree Name | 硕士
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Keyword | 经口咽下颌骨劈开入路
寰椎
枢椎
下颌骨
应用解剖
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Abstract | 目的为经口咽下颌骨劈开入路和经口咽下颌骨劈开扩大入路处理中上颈椎腹侧病变提供解剖学依据。方法对8例成人头颈部解剖标本模拟经口咽-下颌骨劈开及经口咽-下颌骨-舌劈开扩大入路手术,进行逐层的显微外科解剖,并测量相关解剖参数。结果两种经口咽扩大入路的矢状位显露范围 经口咽-下颌骨劈开扩大入路的矢状位显露角度为(62. 49±3. 70)°,经口咽-下颌骨-舌劈开扩大入路的矢状位显露角度为(72.06±2.74)°,经口咽-下颌骨-舌劈开扩大入路其显露范围比经口咽-下颌骨劈开扩大入路扩大了9. 57°,两种经口咽扩大入路矢状位显露角度,经配对t检验统计学方法进行分析,两种经口咽扩大入路矢状位显露角度具有显著差异,具有统计学意义。经口咽-下颌骨劈开扩大入路最大可显露范围为斜坡至C5上终板,经口咽-下颌骨-舌劈开扩大入路最大可显露范围为斜坡至C6上终板。结论 经口咽-下颌骨劈开及经口咽-下颌骨-舌劈开扩大入路行中上颈椎前路手术是安全可行的,适用于斜坡、上颈椎病变同时累及下位颈椎的长节段椎体腹侧病变和弥漫性脊髓腹侧病变,以及由于各种原因导致张口受限或先天性口裂狭小的而不能完成手术的患者。 |
Other Abstract | To provide anatomical profile of the cranio-cervical region for the surgical treatment of ventral atlantoaxial lesions through transoropharyngeal approach. Methods Simulate transoral expanded approach with mandibulotomy and mandibuloglossotomy Surgery on eight Adult head and neck anatomy specimens, microsurgical anatomy was performed layer by layer for observing,and measure relevant anatomic parameters。Results Sagittal exposure range of Two kinds of transoropharyngeal approach,the sagittal exposure angle of transoral approach with mandibulotomy was(62. 49±3. 70),the sagittal exposure angle of transoral approach with mandibuloglossotomy was(72.06±2.74),the exposure range of transoral approach with mandibuloglossotomy increased by 9. 57. compared with transoral approach with mandibulotomy,sagittal exposure angle of Two kinds of transoropharyngeal approach were compared with the pared t test,and differences of the exposure range of two kinds of transoropharyngeal approach is Statistically significant.the maximum exposure range of transoral approach with mandibuloglossotomy is from slop to c6 superior end plate .Conclusion Transoral approach with mandibulotomy and mandibuloglossotomy is safe and feasible which suitable for lesions of slope and upper cervical spine simutaneously involving long segmental vertebral of lower cervical spine ventral and diffuse spinal cord ventral pathological changes,and for congenital mouth narrow crack or restrictionofmouthopening due to various reasons. |
URL | 查看原文
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Language | 中文
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Document Type | 学位论文
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Identifier | https://ir.lzu.edu.cn/handle/262010/223193
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Collection | 学院待认领
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Affiliation | 临床医学院
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Recommended Citation GB/T 7714 |
王克平. 经口咽下颌骨劈开中上颈椎前路手术的解剖研究与临床应用[D]. 兰州. 兰州大学,2015.
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