颈静脉孔区解剖(jiěpōu)颈静脉孔由颞骨岩部和枕骨颈突围成。颞骨和枕骨向孔内的突起分别被称为颞突和枕突，二者以纤维或骨桥连接，构成孔内神经和血管(xuèguǎn)的分隔。由颞突下方沿颈静脉球内侧缘伸向后方的骨性隆起称为颈内嵴，舌咽神经行于其内侧。颈静脉孔为一自颅后窝通向前、外、下方的骨性管道。颈静脉管（jugularcanal）。osseousrelationships,superiorviewthejugularforamenislocatedbetweenthetemporalandoccipitalbonessigmoidgroovedescendsalongthemastoidandcrossestheoccipitomastoidsuture,turnsforwardontheuppersurfaceofthejugularprocess,enterstheforamenfromposteriorandsuperiorshowstheshapeoftheforamenRembrandtvanRijn(Dutch,1606-1669).Thispaintingiscalled"TheAnatomyLectureofDr.NicolaesTulp",paintedin1632颈静脉孔的硬膜结构及分部(fēnbù)nervespenetratetheduraonthemedialsideoftheintrajugularprocess,intrajugularridgeextendsforwardalongthemedialsideofthejugularbulbvagusandaccessorynervespasslateraltotheosseousbridgeandtheinferiorpetrosalsinusdescendsbelowthebridgetoopenintotheinternaljugularvein/arachnoidopenedtoexposetheglossopharyngeal,vagus,andaccessorynervesenteringtheduraandpassingthroughtheintrajugularpartoftheforamen.Aduralseptumseparatestheglossopharyngealnervefromtheuppervagalrootletsatthesiteatwhichthenerveenterstheintrajugularportionoftheforamen.Thejugularduralfoldprojectsoverthenervesastheypenetratethedura颈静脉孔区神经(shénjīng)定位A：Lateralviewofthenormalanatomyofthejugularforamen.B：Axialcut(dottedlineinA)viewedfrominferiortothenormalanatomy.Notethattheperforationsconnectingtheinferiorpetrosalsinustothejugularveinrunbetweenthelowercranialnerves.神经血管结构(jiégòu)的位置关系神经(shénjīng)鞘瘤脑膜瘤颈静脉球瘤颈静脉球体(qiútǐ)瘤Fisch分型法(1978)颈静脉球体(qiútǐ)瘤Glasscock-Jackson分型法(1981)Intracranialgrowthpatternofglomusjugularetumorsintotheinferiorpetrosalsinusglomusjugularmeningioma(M)schwannoma(S).SectionAisatthelevelofthedomeofthejugularbulb,sectionBisatthemidlevelofthejugularforamen,sectionCisattheexitoftheskullbase颈静脉孔区肿瘤(zhǒngliú)手术入路经颈静脉孔入路（transjugularforamen）是极外侧经髁入路的亚型，通过枕下开颅、切除枕髁后1/3、颈静脉突和枕大孔后壁，自后下方显露颈静脉孔。远外侧经髁入路有利于面神经功能和听力的保护，且能对下外侧颅底和颞下窝提供较充分的显露，有助于一期切除颈静脉孔区颅内外沟通性肿瘤，但需进行枕髁、颈静脉结节(jiéjié)切除和椎动脉移位。经髁旁入路切除颈静脉孔区肿瘤，通过切除寰椎横突、移位椎动脉、切除部分枕髁及髁旁、髁上骨质、颈静脉结节(jiéjié