ABSTRACT
Objective To research the jugular foramen,internal auditory pore (IAP)and the turning point between its components by imageological methods and to provide theoretical basis for retrosigmoid approach in the operation of acoustic neurinoma.Methods The skulls of 100 volunteers were scanned to get the final result with thin-section computed tomographic image. High-resolution spiral CT multiplane reformation was used to reform images that were parallel to the Frankfort horizontal plane to measure the distance between the turning point of retrosigmoid (A),the edge of jugular foramen(B)and the lower edge of the internal auditory canal(C)(denoted AC,AB,BC) and the shortest distance from the jugular foramen to AC.The angles between AC,AB and sagittal axis(α,β) were measured.Results The distance of AC was (44.94 ± 3.84)mm,the distance of AB was (43.68 ± 4.56)mm.The distance of BC was (6.15 ±2.04)mm,and the shortest distance between jugular foramen and AC was (5.21±0.23)mm.The angleαwas measured as (39.50±4.74)°,and the angleβwas measured as (46.35± 5.51)°.Conclusion The research measure the distance and angle between entry points and landmarks of retrosigmoid approach and the safe distance.
ABSTRACT
BACKGROUND: Appropriate direction and angle of traction for the vertebral artery type cervical spondylosis(CSA)make significant effect.Selective angiography is recognized as"gold standard"to diagnose the vascular disease.Although magnetic resonance angiography as a non-invasive examination,there exist shortcomings such as a longer time checking,vulnerable to man-made factors,a certain aggressive feature.OBJECTIVE: Through the use of color Doppler flow imaging(CDFI)and transcranial Doppler sonography(TCD)adding the test of turning neck,to analyze the change of blood current parameter before and after the tractions from different directions and angles.METHODS: 240 cases suffering CSA were selected and divided into groups according to anatomy angle of lesion parts(upper cervical segments,lower cervical segments,mixed type)and traction mode,angel(anteversion sitting position 1°-10°,11°-20°,21°-30° groups,posterior extension sitting position 1°-10°,11°-20°,21°-30° groups,neutral position sitting position group).Local massage served as control group.The indexes of vertebral artery of neck part including inner diameter(D)of narrowest location,peak systolic velocity and average velocity of blood were measured by CDFI adding the test of turning neck.The indexes of left vertebral artery,right vertebral artery and basiiar artery including peak velocity(Vp)of period of contraction and mean velocity(Vm)of blood were measured by TCD adding the test of turning neck.RESULTS AND CONCLUSION: ①We determined vertebral artery type of cervical spondylosis on the base of anatomic site. On the basis of diseased region,we divided cervical syndrome into 3 types.They were superior part(C1-C3),inferior part (C4-C6) and commixture.it offers clinical guidance for traction therapy from spondylous morphous and mechanics.② We determined the gbest angle of traction.The therapeutic efficacy in posterior extension sitting position occupying 11-20～was better in upper hind neck;the therapeutic efficacy in anteversion sitting position occupying 11-20° was better in inferior neck; the therapeutic efficacy in anteversion sitting position occupying 1-10° was better in neutral position sitting position.③ We knew that CDFI and TCD are the convenient,non-invasive,safe and reduplicative methods to guide traction therapy in vertebral artery type of cervical spondylosis.