引
言
一、概述
颈内动脉海绵窦段起始于岩舌韧带(petrolingual ligament)的上表面,是颈内动脉破裂孔段的延续。该段被疏松组织、脂肪、静脉丛和节后交感神经所包绕。颈内动脉海绵窦段终止于近端硬膜环,远端为颈内动脉床突段。近端硬膜环是由前床突下表面的骨膜形成的,不完全包绕颈内动脉。
海绵窦段长度平均18mm(14.5-23.0mm),直径平均5.4mm(4.0-7.0mm)。
Bouthillier颈内动脉分类法示意图(Bouthillier 1996)。
![](https://res.medtion.com/uploads/1/image/public/202007/20200724183721_c5xyisxewg.png)
![](https://res.medtion.com/uploads/1/image/public/202007/20200724183721_vgk582iu8u.png)
![](https://res.medtion.com/uploads/1/image/public/202007/20200724183721_iu3irmsy48.png)
![](https://res.medtion.com/uploads/1/image/public/202007/20200724183722_dg6qeia7s9.png)
二、分段
颈内动脉海绵窦段的分段(Bouthillier 1996)。
右侧海绵窦侧面观,显示颈内动脉海绵窦段的分界以及分为五段(Rhoton 2002)。
![](https://res.medtion.com/uploads/1/image/public/202007/20200724183723_x46dvn8qpg.png)
![](https://res.medtion.com/uploads/1/image/public/202007/20200724183724_d7m70kwoof.png)
三、形态
根据颈内动脉虹吸部侧位的形态的分类示意图(Griessenauer 2015)。
![](https://res.medtion.com/uploads/1/image/public/202007/20200724183724_apxum1q8nm.png)
![](https://res.medtion.com/uploads/1/image/public/202007/20200724183724_c4qxrx6ocd.png)
![](https://res.medtion.com/uploads/1/image/public/202007/20200724183724_srg63qe2pp.png)
![](https://res.medtion.com/uploads/1/image/public/202007/20200724183725_gakm3k54ef.png)
四、海绵窦段主要分支
颈内动脉海绵窦段的主要分支包括:
(一)脑膜垂体干(meningohypophyseal trunk)
典型者发自颈内动脉海绵窦段后膝外侧缘,主要有三个分支:
① 小脑幕动脉(tentorial artery),又称为Bernasconi-Cassinari动脉;
② 垂体下动脉(inferior hypophyseal artery);
③ 脑膜背侧动脉(dorsal meningeal artery),又称斜坡外侧动脉(lateral clival artery)。
颈内动脉海绵窦段分支示意图,背侧观(Tubbs 2007)。右侧鞍背和斜坡已切除。
![](https://res.medtion.com/uploads/1/image/public/202007/20200724183725_53ryeda26f.png)
五、分支类型
![](https://res.medtion.com/uploads/1/image/public/202007/20200724183725_04ofng4xpe.png)
![](https://res.medtion.com/uploads/1/image/public/202007/20200724183725_cwofeeoy1e.png)
![](https://res.medtion.com/uploads/1/image/public/202007/20200724183725_mhw84h10mh.png)
![](https://res.medtion.com/uploads/1/image/public/202007/20200724183726_ly3662x6m5.png)
![](https://res.medtion.com/uploads/1/image/public/202007/20200724183726_jy0yelmgqb.png)
![](https://res.medtion.com/uploads/1/image/public/202007/20200724183726_o0c3fxfahw.png)
六、走行变异
(一)颈内动脉海绵窦段突向蝶鞍
![](https://res.medtion.com/uploads/1/image/public/202007/20200724183726_umrl8j64nv.png)
(二)颈内动脉海绵窦段突向蝶窦
![](https://res.medtion.com/uploads/1/image/public/202007/20200724183726_311m14isr7.png)
(三)颈内动脉海绵窦段突向颅内
![](https://res.medtion.com/uploads/1/image/public/202007/20200724183727_wwqy666yfo.png)
![](https://res.medtion.com/uploads/1/image/public/202007/20200724183727_ygh2ujhq8e.png)
七、小结
八、作者简介
九、参考文献
Bouthillier, A., van Loveren, H. R., & Keller, J. T. (1996). Segments of the internal carotid artery: a new classification. Neurosurgery, 38(3), 425-432; discussion 432-423.
Gottfried, O. N., Soleau, S. W., & Couldwell, W. T. (2003). Suprasellar displacement of intracavernous internal carotid artery: case report. Neurosurgery, 53(6), 1433-1434; discussion 1434-1435.
Griessenauer, C. J., Yalcin, B., Matusz, P., Loukas, M., Kulwin, C. G., Tubbs, R. S., & Gadol, A. A. (2015). Analysis of the tortuosity of the internal carotid artery in the cavernous sinus. Childs Nerv Syst, 31(6), 941-944.
Inoue, T., Rhoton, A. L., Jr., Theele, D., & Barry, M. E. (1990). Surgical approaches to the cavernous sinus: a microsurgical study. Neurosurgery, 26(6), 903-932.
Jittapiromsak, P., Sabuncuoglu, H., Deshmukh, P., McDougall, C. G., Spetzler, R. F., & Preul, M. C. (2010). Anatomical relationships of intracavernous internal carotid artery to intracavernous neural structures. Skull Base, 20(5), 327-336.
Osawa, S., Rhoton, A. L., Jr., Tanriover, N., Shimizu, S., & Fujii, K. (2008). Microsurgical anatomy and surgical exposure of the petrous segment of the internal carotid artery. Neurosurgery, 63(4 Suppl 2), 210-238; discussion 239.
Renn, W. H., & Rhoton, A. L., Jr. (1975). Microsurgical anatomy of the sellar region. J Neurosurg, 43(3), 288-298.
Rhoton, A. L., Jr. (2002). The cavernous sinus, the cavernous venous plexus, and the carotid collar. Neurosurgery, 51(4 Suppl), S375-410.
Schuenke, M., Schulte, E., & Schumacher, U. (2016). Thieme Atlas of Anatomy Head Neck and Neuroantomy. New York: Thieme Medical Publishers.
Tubbs, R. S., Hansasuta, A., Loukas, M., Louis, R. G., Jr., Shoja, M. M., Salter, E. G., & Oakes, W. J. (2007). Branches of the petrous and cavernous segments of the internal carotid artery. Clin Anat, 20(6), 596-601.
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