The Microanatomic Of Far Lateral Transcondylar Approach And Application

Objective:To study the microsurgical anatomy related to far lateral transcondylar approach,to explore the impact of resection of occipital condyle and Jugular tubercle on operative filedMethods: 10 adult cadaveric heads were anatomied from muscle layer,epidural layer to intradural layer by far latera transcondylar approach. Measure the three distances from operative field farthest point to the middle respectively before Occipital condyle was dilled,after Occipital condyle was dilled to the inside mouth of the hypoglossal canal,after jugular tubercle was dilled.Result:the distance from Vertebral artery into the dura mater at the midpoint of the foramen magnum to the left side was (22.94±1.78) mm, to the right side was (23.22±1.57) mm. The length of theV3h of the vertebral artery on the left was (24.72±1.26) mm ,on the right was (24.94±1.50) mm.The distance from transverse foramen of atlas to outer of the Transverse process of atlas on the left was (11.93±0.96)mm, on the right was(12.29±0.83)mm. The distances from operative field farthest point to the middle: before Occipital condyle was dilled -4.70±0.43 mm (left), - 4.71±0.37 mm(right); After Occipital condyle was dilled to the inside mouth of the hypoglossal canal -1.11±0.42 mm(left), -1.08±0.19 mm(right); after Occipital condyle was dilled to the inside mouth of the hypoglossal canal and after jugular tubercle was dilled 2.38±0.42 mm (left),2.58±0.26 mm (right). 3 sets of data by statistical comparison p <0.05 were statistically significant.Conclutions:1. Familiar with the anatomical location of the suboccipital triangle muscle, posterior belly of digastric and the lateral rectus was beneficial with intraoperative protection of the vertebral artery and the facial nerve and other important organizational structure.2. V3 segment of vertebral artery varied greatly sothat wo can according to the location of the atlas transverse process and nerves C2 , anatomy of V3 segment of vertebral artery and quantitative determination of its surrounding structures to protect vertebral artery during opreation.3.After after Occipital condyle was dilled in the far lateral approach, surgical vision and operation of space expanded, the wear of jugular tubercle could significantly increase surgery angle and medullary junction view. Dilling the Occipital condyle from1 / 3 to 1 / 2 can remove the ventral and ventrolateral medulla oblongata lesions, does not affect the stability of the atlanto occipital.