沿鼻中隔经蝶窦行垂体瘤切除微创入路探讨

目的 :为临床行垂体瘤切除术微创手术入路 ,提供解剖学参考依据。方法 :甲醛固定成年头颈正中矢状切上肢标本 90例 (男 5 2例、女 38例 ) ,进行定位、测量 ,然后在尸体整头标本上模拟手术。结果 :测得鼻前棘至腭正中缝后端的距离 :男性 (5 .0 7± 0 .18) cm,女性 (4 .85± 0 .17) cm ;腭正中缝后端至交叉前沟后缘中点的连线 :男性 (4 .2 1±0 .18) cm,女性 (3.93± 0 .14 ) cm;腭正中缝后端至鞍背前缘中点的连线 :男性 (4 .5 0± 0 .17) cm,女性 (4 .17± 0 .16 ) cm;腭正中缝后端至交叉前沟后缘中点连线与腭正中缝后端至鞍背前缘中点的连线之间角 :男性 (16 .1± 0 .8)°,女性 (15 .2± 0 .7)°。结论 :腭正中缝后端至交叉前沟后缘中点 ,腭正中缝后端至鞍背前缘中点及腭正中缝后端至垂体窝最低点 ,从此区行垂体瘤切除术 ,作为微创手术入路及手术区域 ,从解剖角度考虑是可行的

The Along the Nasal Septum Through the Sphenoidal Sinus Line to Perform the Operation for Removing Hypophysis Tumor

Objective To provide anatomical conference for seeking entrance to the slight damage operation for clinically removing hypophysis tumor.Methods 90 adult corpses (male 52,female 38)with formalin fixed head and neck were vertically cut from the median together with the arms and then located and measured Afler that,simulated operation was performed on the specimen of the intact skull.Results The distance between the nasal anterior apine and the posterior end of the palate median suture has been measried male (5.07±0.18)cm,female (4.85±1.6)cm,The connecting line from the posterior end of the palate median suture to the middle point of the posterior margin of the cross anterior sulcus is male (4.21±0.18)cm,female (3.93±0.14)cm,The connecting line from the posterior end of the palate median suture to the middle point of the ridge anterior margin is male (4.50±0.17)cm,female (4.17±0.16)cm.The angle between the above two connecting line is male (16.1±0.8)°,female (15.2±0.7)°.Conclusion It is feasible to perform the excision of the hypophysis tumor from the posterior end of the palate median suture to the middle point of posterior margin of the anterior sulcus, from the posterior end of the ridge anterior margin and from the posterior end of the palate median suture,from the posterior end of the ridge anterior margin and from the posterior end of the palate median suture to the lowest point of the hypophysial fossa.And this region is ,anatmically,the good entrance of slight-damage operation and it can be the good region for performing the operation.