摘要
目的研究翼点入路相关脑池的显微解剖及内镜解剖,为内镜辅助下经翼点入路进行鞍区显微手术提供解剖学依据。方法在15例尸头上经翼点入路开颅后,交替使用显微镜和内镜,利用鞍区自然的解剖间隙对鞍区脑池及其内结构进行观察,并将两者观察的结果进行比较。结果利用内镜可以更广泛地显示对侧ICA内侧壁及其发出的分支及穿支,并从正面显示垂体柄及鞍隔;可以协助观察术侧的ICA内侧壁及其发出的分支及穿支,PcoA及其发出的穿支动脉,并从侧面观察到垂体柄的全长及其表面的穿支动脉;通过打开的Liliequist膜可以更清晰,更广泛地显示BA及分叉,双侧的PCA,SCA,动眼神经。利用成角的内镜可以清晰地显示PcoA和AchA下壁,AcoA发出的下丘脑穿支及三脑室底部结构。结论运用内镜可以消除经翼点入路进行鞍区显微手术的显微镜观察的死角,减少术中为暴露深部病变而对脑组织及重要颅底血管和神经的牵拉,从而提高鞍区手术的疗效。
Objective To study the microanatomy and endoscopic anatomy of the cerebral cisterns in the sellar region related to pterional approach and to provide the anatomic basis for endoscope-assisted microneurosurgery in the sellar region. Methods Fifteen cadaver heads were dissected through pterional approach and the cisterns in the sellar region were studied by both the microscope and endoscope, by which the outcomes observed were recorded and compared. Results The medial wall of the contralateral ICA and its branches, the lateral side of pituitary stalk, and sellae diaphragma can be observed well by the endoscope. BA and its bifurcation, bilateral PCA, SCA and oculomotor nerve can be observed well after the opening of the Liliequist membrane. The basal wall of the PcoA and AchA, AcoA and its basal peforating branches, and the third ventrical floor can be seen well by the angled endoscope. Conclusion An endoscope can be used to enhance the visible field of an operating microscope. The endoscope-assisted microneurosurgery may increase the curative effect on the lesions in the sellar region.
出处
《中国临床神经外科杂志》
2005年第4期248-251,共4页
Chinese Journal of Clinical Neurosurgery
关键词
翼点入路
脑池
显微外科解剖
神经内镜解剖
Pterional approach
Cerebral cisterns
Microanatomy
Endoscopic anatomy
