| Objective: 1.Description the bilateral of transverse sinus' s shape and rule of drainage,Measuring and positioning the location of the bilateral transverse sinus,To calculate the groove of transverse sinus' s depth and thickness,Summarizes how to use surface marker to pinpoint the location of the transverse sinus in operation,Measurement of bilateral internal jugular vein and external jugular vein in the end of the common carotid artery in cross-sectional area.2.Discuss the operation of the transverse sinus-internal jugular vein or external jugular vein bypass to treatment the areas of transverse sinus,sigmoid sinus,and on the Jugular foramen lesions.Material and Method: Select 100 cases in outpatient CTA examination for adults in China all the image data,Out of the window of bone and blood vessels in computer reconstruction image data is established in the midline attachment for Y,The origin for the highest the inion,With Y vertical rectangular coordinate system for the X axis,Measurement of transverse sinus in-40 mm to 40 mm range coordinate system data,Will the right transverse sinus groove on the edge points in turn named point 1a?1b?1c?1d?1e?1f?1g?1h,Will be on the right side of inferior margin of the transverse sinus groove points in turn named 2a?2b?2c?2d?2e?2f?2g?2h;Respectively on the left of the-1a and-1b?-1c?-1d?-1e?-1f?-1g?-1h and-2a?-2b?-2c?-2d?-2e?-2f?-2g?-2h.And record each hole midpoint coordinates,Then quantitative anatomical location of the transverse sinus.Measure the bilateral transverse sinus the depth of the groove in the interval and its distance from the recent distance on the surface of the skull.Compare the protuberantia occipitalis interna and the location of the relationship between the inion.In the selection of image data,respectively on the bilateral common carotid artery at the end of the level measure the internal jugular vein of sternocleidomastoid inside cross-sectional area and the surface of the sternocleidomastoid external jugular vein cross-sectional area.And through the circle formula to calculate the area of its diameter.In 20 cases cadaveric base specimens posterior fossa craniotomy surgery and revealed the location of the transverse sinus,to accurately verify the contorts and positioning to provide the anatomical basis of transverse sinus.Result:Transverse sinus is on the right side of advantage accounted for 56%,The absolute advantage is 8%,Comparative advantage is 28%,A little advantage accounted for 20%;Transverse sinus is on the left side of the edge is accounted for 20%,The absolute advantage is 4%,Comparative advantage is 4%,A little advantage accounted for 1.2%.And on both sides of the little difference of 24% of the cases.By studying the transverse sinus groove contorts we found that the left transverse sinus to lower than the right side,and on the left side of the transverse sinus contorts when bending degree of smaller than the right side.The right transverse sinus groove all coordinates of points on the Y axis average respectively: 1a:28.18±2.13,1b:25.34±2.19,1c:20.29±1.76,1d:17.94±1.69,1e:16.98±1.21,1f:16.66±1.03,1g:14.97±2.08,1h:12.98±2.12;2a:15.74±2.24,2b:11.24±2.1,2c:9.46±1.20,2d:7.34±2.57,2e:7.12±2.28,2f:7.09±1.13,2g:4.26±1.60,2h:3.28±1.41.The left transverse sinus groove all coordinates of points on the Y axis average respectively:-1a:19.91±1.41,-1b:17.45±2.14,-1c:15.42±2.12,-1d:15.07±2.2,-1e:14.61±1.71,-1f:14.35±2.01,-1g:12.92±1.91,-1h:12.2±2.01;-2a:10.87±2.11,-2b:8.47±1.67,-2c:7.38±1.81,-2d:7.23±3.03,-2e:6.93±1.65,-2f:5.47±2.13,-2g:4.57±1.89,-2h:4.50±2.11?The right internal jugular vein cross-sectional area of the average was125.44±23.18mm2,With the advantage is on the right side of the average cross-sectional area for patients was 159.32 ± 20.31 mm2,With the advantage is on the left side of the average cross-sectional area for patients was 64.92±21.02 mm2.On the left side of the internal jugular vein cross-sectional area of the average was113.26±19.25mm2.With the advantage is on the left side of the average cross-sectional area for patients was 138.79 ± 28.99mm2,With the advantage is on the right side of the average cross-sectional area for patients was 74.98±12.18mm2.On the right side of the average cross-sectional area of external jugular vein was 47.34±6.23mm2,The average cross-sectional area for the left external jugular vein was42.22±5.86mm2,and no significant statistical differences between the two side.In all cases,larger on the right side of the neck vein cross-sectional area is 45%,the left side is large is 51%,outside on the right side of the neck vein in level at the end of the common carotid artery in short of sternocleidomastoid surfaces such as 3%,the left side is 1%.Compared with the protuberantia occipitalis interna and the inion,the higher the protuberantia occipitalis interna in the inion accounted for 76%,these cases the protuberantia occipitalis interna is higher than average the inion about 9.03±2.11 mm;the protuberantia occipitalis interna is lower than the inion accounted for 13%,on average than low 8.03±1.86 mm to the inion;both at the same level of 11%.The transverse sinus groove within 40 mm from the centre line average maximum depth is about2.89±0.79 mm,The deepest and transverse sinus groove to skull appearance is the average thickness is about 8.24±1.31 mm.Conclusion:1.Know the location of the transverse sinus and contorts preoperatively will help to improve the security of during neurosurgery;2.Preoperative understand internal jugular vein and external jugular vein diameter and cross-sectional area helps to preoperative design scheme;3.For transverse sinus,sigmoid sinus,and on the internal jugular vein segment lesions,While can't by conventional treatment or conventional treatment difficult,could be consider the operation of the transverse sinus-internal jugular vein or external jugular vein bypass;4.The operation of the transverse sinus-internal jugular vein or external jugular vein bypass is relatively safe,effective and a simple way. |
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