蝶骨嵴锁孔入路的显微外科解剖

目的:掌握经蝶骨嵴锁孔入路显露鞍周结构的显微外科解剖,探讨该入路治疗颅内病变的可行性.方法:14例(28侧)10%甲醛溶液固定尸体头颅标本模拟蝶骨嵴锁孔入路,借助手术显微镜通过鞍区手术间隙对鞍区重要结构进行显微解剖.结果:对颈内动脉床突上段及其分支、基底动脉顶部、垂体柄等鞍周重要结构进行良好的显露和观测,并获得重要参数.结论:蝶骨嵴锁孔入路适用于显露大部分前循环动脉瘤及前颅底后方、鞍旁、蝶骨嵴、颞极、中颅窝底前部病变.

Microsurgical Anatomy Related with Sphenoid Ridge Keyhole Approach

Objective:To study the microsurgical anatomy of exposing the peri-sellar region via sphenoid ridge keyhole approach,and discuss the feasibility of this approach in treating intracranial lesions.Methods:Fourteen adult cadaveric heads (28 sides) fixed in formalin were used to study the sphenoid ridge keyhole approach.The peri-sellar region was examined through the operating spaces in the sellar region under microsurgical microscope.Results:Sphenoid ridge keyhole approach can provide excellent exposure for the important structures of the peri-sellar region,such as the supraclinoid portion of the internal carotid artery and its branches,the apex of the basilar artery,and the pituitary stalk through the operating spaces in the sellar region.Conclusions:We recommend this approach for treatment of the majority of anterior circulation aneurysms and intracranial lesions in posterior of the anterior cranial base,parasellar region,sphenoidal crest,and temporal pole and anterior of the middle cranial base.