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中年男性标本15例,采用Plastination技术,分别作成颅底部蝶鞍区的三维薄层断面标本,进行巨微解剖学观测。结果显示,垂体的左右径大于前后径或上下径,对于垂体病变的影像诊断,宜进行三方位的对照观察,以了解垂体的形态变化。垂体两侧紧靠颈内动脉,颈内动脉扩张、迂曲,将使其间隙发生改变,甚至压迫垂体,有时也会造成经蝶窦垂体手术的困难。经冠状断面的显微观察,展神经与海绵窦外侧壁之间有间隙存在,说明展神经并不走行于外侧壁中,而是位于海绵窦内。颈内动脉行经海绵窦内,并与海绵壁之间形成几个间隙,间隙的大小与颈内动脉的形态位置关系极为密切,影像观察时宜注意这一形态特点。紧贴视交叉的外侧,颈内动脉由海绵窦段的前升部穿过鞍膈移行为床突上段,此处为两侧颈内动脉相距最近点,两动脉之间距离仅为11.5mm,在经额经视交叉下入路的垂体手术时,应注意到这一毗邻关系,以免造成此处颈内动脉的损伤。海绵窦外侧壁的手术入路,除滑车神经与眼神经之间的Parkinson’s三角外,经形态学观测,在其前半部,尚有眼神经与上颌神经之间的间隙;在其中部,有动眼神经与滑车神经之间的间隙可供选择。
Fifteen middle-aged male specimens were examined by microscopic anatomy using Plastination technique to make three-dimensional thin sections of the skull base sellae area respectively. The results showed that the left and right diameter of the pituitary is greater than the anteroposterior diameter or the diameter of the upper and lower diameter, the imaging diagnosis of pituitary lesions should be three-way control observation to understand the morphological changes of pituitary. Close to the internal carotid artery on both sides of the pituitary, internal carotid artery dilatation, tortuous, will make its gap change, or even oppression of the pituitary, and sometimes can cause transversal pituitary surgery difficulties. The microscopic observation of the coronal section shows that there is a gap between the nerve and the external wall of the cavernous sinus, which means that the nerve does not walk in the lateral wall but is located in the cavernous sinus. The internal carotid artery runs through the cavernous sinus and forms several gaps with the sponge wall. The size of the internal carotid artery is closely related to the shape and location of the internal carotid artery. This morphological feature should be noticed in the image observation. Close to the outer side of the optic chiasm, internal carotid artery from the anterior segment of the cavernous segment through the saddle diaphragmatic shift for the upper bed, here on both sides of the internal carotid artery closest point, the distance between the two arteries was only 11.5mm , In the amount of transciliary approach pituitary surgery, should be aware of this adjacent relationship, so as to avoid damage to the carotid artery here. Surgical approach to the lateral wall of the cavernous sinus, except for the Parkinson’s triangle between the trochlear nerve and the oculomotor nerve, was observed morphologically. In the first half of the cavernous sinus there was a gap between the oculomotor nerve and the maxillary nerve. In the middle part, Gaps between the nerve and the trochlea nerve are available.