颞下锁孔入路的显微解剖与临床应用

目的进行颞下锁孔入路解剖学研究,探讨其临床应用价值.方法取甲醛固定的成人尸头标本15例(30侧),采用神经内镜辅助的显微外科技术进行颞下锁孔手术解剖学研究.并采用该入路手术切除8例颅内肿瘤.结果颞下锁孔入路可以充分暴露鞍上区、脚间窝、岩斜区及脑干腹外侧区的神经、血管结构;岩骨尖最大磨除面积为306mm2.肿瘤全切除7例(87.5%).结论经颞下锁孔入路能很好地处理鞍上、岩斜区、脚间窝以及脑干腹外侧区的病变.

Subtemporal keyhole approach:microanatomy and clinical application

Objective To study the anatomy of subtemporal keyhole approach, and investigate its value in clinical application. Methods Anatomic features were studied in 30 sides of adult embalmed cadaver heads perfused with colored silicone, using microscope and neuro-endoscope. The approach was used in 8 patients, and the indications for surgery were based on the position, pathology and size of the lesions. Results The neurovascular structures of the suprasellar, petroclival, interpeduncular cistern and prepontine cistern can be well exposed via this approach, and the ventral-lateral pontine and the cerebellopontine angle (CPA) can also be well exposed. The maximum area of the resection of the petrous apex can be extended to 306 square millimeters. The tumors in seven of eight consecutive patients were totally removed (87.5%). Conclusion The subtemporal keyhole approach has been proven to provide sufficient operating space and obtain satisfactory outcomes for the lesions in the region of suprasellar, petroclival, ventral-lateral pontine, interpeduncular cistern and prepontine sistern.