论文部分内容阅读
目的:研究神经内镜下眶上锁孔入路的解剖特点,探讨其在手术中的应用价值。方法:8例成人尸头,取眶上锁孔入路,在手术显微镜和内镜下观察鞍区和鞍旁区,观察和测量其内容及比邻关系。结果:测量颧突至同侧及对侧视神经管颅口、同侧及对侧前床突尖、同侧及对侧后床突尖的距离。额骨颧突内板到同侧前床突的距离最短,为 (5.96±0.22)cm;到对侧后床突尖距离最长,为(8.11±0.28)cm。额骨颧突内板与同侧后床突尖的轴位水平夹角最小,为(32.58±3.44)°,与对侧前床突尖的轴位水平夹角最大,为(50.33±3.44)°。通过不同角度内镜及解剖间隙,能够观察到鞍区结构,前循环血管各部。结论:该入路可作为鞍区和鞍旁区肿瘤切除、动脉瘤夹闭、经终板第三脑室造瘘、视神经管减压等手术的常用手术人路,熟悉入路中各结构间的相互位置关系距离对术中定位有很大帮助。
Objective: To study the anatomic features of the supraorbital keyhole approach with endoscopic treatment and to explore its application value in surgery. Methods: Eight adult cadaver heads were treated with supraorbital keyhole approach. The sellar region and the parasellar region were observed under operating microscope and endoscope. The contents and adjacent relationship were observed and measured. RESULTS: The distance between the zygomatic process and the tip of the anterior bed in the ipsilateral and contralateral optic canal, and the distance between the ipsilateral and contralateral anteroposterior cusps, was measured. The distance between frontal zygomatic medullary board and ipsilateral anterior prominence was the shortest (5.96 ± 0.22) cm, the longest distance to the contralateral posterior bed was (8.11 ± 0.28) cm. The angle between the frontal zygomatic medial plate and the ipsilateral posterior apex of the frontal gyrus was the smallest, which was (32.58 ± 3.44) ° and the largest was the axial level (50.33 ± 3.44) °. Through different angles of endoscopic and anatomical gap, can be observed in the structure of the saddle area, before the circulation of blood vessels. Conclusion: The approach can be used as a commonly used surgical approach for sectoral resection of sellar region and parasellar region, aneurysm clipping, endoscopic third ventriculostomy, optic canal decompression and other surgical procedures, familiar with the various structures The distance between the location of each other is very helpful for intraoperative positioning.