Anatanical Research Of Transoraltranspharyn-geal Approach

【Objective】To provide allround data for guiding relatively clinical surgical operation by measuring relative anatomical numerical value from transorpharyngeal approach to trachel-pulvinar junctional zone. To select better surgical instruments and methods before the operation; to enlarge exposing area and decrease the injury of important structure in the operation; to raise the achievement ratio of operation;to decrease postoper-ative complications and to depress mortality rate and Invalid rate;to raise the living quality of patients.【Methods】1 To choise the skulls , 10 horizontal planes ; 20 body example of pate in which there is 10 median sagittal planes.2 To measuring ,by vernier caliper,the distance from spina nasalis anterior to pharyngeal tubercle,2the depth from posterior wall of pharynx to inner vertebral canal at level of foramen magnum ,3the depth from posterior wall of pharynx to inner vertebral canal at level of anterior arch of atlas,4the depth from posterior wall of pharynx to inner vertebral canal at level of body of axis, 5from confluens point of amphi-vertebral artery to middle point of anterior border of great occipital foramen. Reading the numerical value ,by vernier caliper,from compasses measuring as followed : foramen incisive to pharyngeal tubercle,spina nasalis anterior to pharyngeal tubercle,spina nasalis posterior to pharyngeal tubercle,anterior part of great occipital foramen to pharyngeal tubercle, inner border of outer entrance of oval foramen to pharyngeal tubercle,inner border of lacerated foramen to pharyngeal tubercle,inner border of outer entrance of carotid canal to pharyngeal tubercle , inner border of outer entrance of hypoglossal canal to pharyngeal tubercle,inner border of outer entrance of oval foramen to central line, inner border of lacerated foramen to central line,inner border of outer entrance of carotid canal tocentral line,inner border of outer entrance of hypoglossal canal to central line, height of slope,height of anterior arch of atlas,omni-height of axis(containing odontoid process),inner border of vertebral artery to central line at level of atlas,inner border of vertebral artery to central line at level of axis , external diameter of amphi-vertebral artery.3 The statistics of data .4 To calculate the general average and standard error of all the items by the statistics software .5 Compare the data to the articles of same kind . To observe if is there some questons .【Results】1 The distances from foramen incisive to pharyngeal tubercle, spina nasalis anterior to pharyngeal tubercle, spina nasalis posterior to pharyngeal tubercle, anterior part of greatoccipital foramen to pharyngeal tubercle are as follows: 72.12±4.25,77.77±3.89,33.73±2.07,13.14±1.91mm.The data above suggest the distance relationship of the important bony markers for operative approach. 2 The height of slope,height of anterior arch of atlas,height of omni-height of axis(containing odontoid process) are: 34.80±3.66 ( 28.34 - 40.38 ) , 11.72±2.11(8.09-17.51), 32.61±2.82(27.60-40.03).The data above provide the length wise from slope to axis.3 At level of foramen magnum and anterior arch of atlas and body of axis,the depths from posterior wall of pharynx to inner vertebral canal are : 21.51±2.03(25.55-7.72), 30.62±1.52(32.22-28.34),23.82±1.97(26.74-20.35).The data above provide the tissular depths from Operative incision to inner vertebral canal during the operation.4 The distance from inner border of left vertebral artery to central line at C1 level is 25.51±2.03(21.55-28.72),the right side is 25.62±2.02(22.22-30.34);the distance from inner border of left vertebral artery to central line at C2 level is 18.63±2.11(13.72-21.33), the right side is 18.83±2.24(12.74-21.25).The distance from confluens point of amphi-vertebral artery to middle point of anterior border of great occipital foramen,which is mesured for the first time, is 20.65±3.24(12.98-26.87).【Conclusions】With regard to the eccope of gastr-process at the central line in the cranio-cervicum junctional zone,the short distance and single anatomy layer make the operation feasible in the condition of euthyphoria. Even though when handling the process of cerebral dura mater, the drag with medulla oblongata and Cervical spinal cord and the definitive pairs of cranial nerve can be avoided.So as long as if only the indication selected appropriately, this operative approach is the best choice with the eccope of gastr-process in the cranio-cervicum junctional zone.After the statistical test,it is justifed that the operative principles for the transorpharyngeal approach to trachel-pulvinar junctional zone is suitable to the people for North China.