神经内窥镜下侧脑室和第三脑室手术的应用解剖学研究

目的：研究神经内窥镜下侧脑室、第三脑室的解剖结构和影像学特点,为临床开展神经内窥镜脑室手术提供解剖学依据。方法：在10例成人尸头和25例脑积水第三脑室底造瘘手术病人神经内镜下观察侧脑室、三脑室在内镜下的解剖结构,并录象作记录和研究之用。结果：额角入路可以观察到侧脑室额角和侧脑室体部,且可以通过室间孔进入第三脑室。室间孔的Y形结构是脑室内观察和定位的重要标志。枕角、三角区和颞角入路分别可观察到侧脑室相应部位和脉络丛。结论：侧脑室额角入路是观察侧脑室和三脑室的最常用入路,观察侧脑室范围最大,也是第三脑室底造瘘的最佳入路,枕角入路便于对侧脑室三角区和侧脑室体后部病变的观察和治疗,三角区和颞角入路很少用到．

Applied anatomy of the lateral ventricle and the third ventricle :neuroendoscopic study

Objective: To investigate the anatomic and imageologic characteristics of lateral ventricle and the third ventricle by neurendoscopy and to provide anatomic basis for clinical applications. Methods: The anatomic characters of the lateral ventricle and the third ventricle were observed in 10 cadavers and 25 hydrocephalus patients, while the endoscopic observation of lateral ventricle and the third ventricle were performed recorded. Results: The body and front horn of the later ventricle could be observed via front horn approach which is the most popular approach for endoscopic third ventriculostomy. The "Y" shape structure of the Monroe hole was the significant mark to observe and locate the ventricle. The corresponding parts of lateral ventricle and choroid plexus could be observed via the approaches of occipital horn, triangular area and temporal horn of the ventricle. Conclusions: The view field is the largest via the front horn approach that is commonly used to the endoscopic operation of the lateral ventricle and the third ventricle. The occipital horn approach is useful for endoscopic operation of the posterior part and triangular area of the lateral ventricle. The approaches through triangular area and occipital horn are used seldom.