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Bypass Surgery of the Petrous Segment of Internal Carotid Artery Via the Extended Middle Fossa Approach: An Mocrosurgical Anatomy and Animal Experimental Research

Author: DuRan
Tutor: ZhangYi
School: Fudan University
Course: Neurosurgery
Keywords: Expanding the base of the skull approach Internal carotid artery Vascular bypass Dog Animal models High flow
CLC: R322.8
Type: Master's thesis
Year: 2011
Downloads: 28
Quote: 0
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Abstract


Part I: expanding Surgical approaches in the internal carotid artery petrous bone segments Objective To study the microscopic anatomy of the enlarged skull base surgical approach to the internal carotid artery petrous bone segment and its adjacent structures around anatomical features, clinical surgery anatomy Fundamentals. The six arterial perfusion latex adult cadaver head analog surgical approach to expand in the base of the skull, petrous bone segment observation of the internal carotid artery and its section under the microscope, the branch, the greater superficial petrosal nerve, geniculate ganglion, cochlea, the inner anatomical relationship of the auditory canal and measurement. The results the carotid artery rock bone segment is divided into three segments of the horizontal section, the knee, the vertical segment, expanding the base of the skull into the road can be exposed to the three sections of the average distance were 9.1 ± 1.1mm, 3.8 ± 0.3mm, 10.2 ± 1.5mm vessel diameter were 5.5 ± 0.4mm, 5.4 ± 1.Omm, 5.2 ± 0.7mm. This experiment was not found with a branch. Pulled forward V3 increase the petrous bone segment ICA exposed length of 4.0 ± 0.5mm (P lt; 0.05). The foramen spinosum Arcuate uplift superficial petrosal nerve, geniculate ganglion expand the important anatomic landmarks in skull base surgery approach. Bone segment of the internal carotid artery rock, cochlea, internal auditory canal is to expand the important anatomic structures in the skull base approach in the surgical approach. Conclusion petrous bone segment of the internal carotid artery has few branches, and the advantages of large diameter, is the appropriate parts of the extracranial and intracranial vascular bypass. The pulled forward V3 significant increase in the petrous bone segment exposed length of the ICA (P lt; 0.05), here line vascular bypass surgery provides longer operating distance. Expanding the base of the skull into the road trip rock the bone segments ICA bypass a deal with good secondary surgical site lesions. Part II: The purpose of intracranial and extracranial internal carotid artery system high flow bypass animal model through simulation expand in Surgical approaches to the establishment of a large animal external carotid artery - intracranial internal carotid artery system high flow bypass and perioperative observation model, high-flow vascular bypass surgery for intracranial and extracranial clinical application, and worked out a set of the completion of the surgery required for clinical practice training mode, related to neurosurgery, vascular surgery, skull base surgeons provide simulation training platform. Beagles 2 body weight between 9Kg-10Kg. Preoperative intramuscular injection the ketamine hydrochloride 10mg/Kg, implementation of basic anesthesia. Establishment of intravenous access, ketamine hydrochloride the anesthesia induction 2mg/Kg intubation convergence anesthesia machine assisted breathing. Ketamine anesthesia was maintained. Select direct terminal branches of the external carotid artery internal maxillary artery is not into the bone section as a of bypass starting point, the branch of the middle cerebral artery in the sylvian as TDC, take the dog femoral artery bypass grafts intracranial and extracranial artery bypass graft surgery. Line immediately after whole brain artery figures silhouette angiography (DSA) the observed vascular bypass unimpeded results of two Beagles (side) the microscope down internal maxillary artery - middle cerebral artery M2 segment high-flow vascular bypass surgery, made model, smooth surgery without anesthesia accident, graft patency, operative time for 7-9 hours. Postoperative DSA by transplant blood supply M2 segment of the middle cerebral artery, both ends of the anastomosis and graft patency. Conclusion the canine intracranial and extracranial internal carotid artery system model of high-flow vascular bypass, with material similar to high flow, blood pressure similar to a smooth surgery, the advantages of the patency rate, closer to the real surgical procedure intracranial and extracranial carotid artery high flow bypass can wish to master the technology of high-flow vascular bypass surgeons provide simulation training platform closer to the real surgical process.

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CLC: > Medicine, health > Basic Medical > Human morphology > Human Anatomy > Nervous system
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