显微镜与内镜下不同纵裂入路的结构显露特点及其解剖结构标志定位

目的探讨显微镜与内镜下不同纵裂入路的结构显露特点及解剖结构标志定位。方法成人尸头10具,分为A组和B组,每组5具,分别采用经前额纵裂入路和经纵裂胼胝体脉络膜裂入路联合室内孔入路,在显微镜和内镜下观察内部结构。结果显微镜与内镜下经前额纵裂入路微创并可充分显露和定位鞍区和第三脑室,有利于切除第三脑室前部和鞍区肿瘤,而经纵裂胼胝体脉络膜裂入路联合室内孔入路微创并可充分显露和定位第三脑室及侧脑室解剖结构,有利于第三脑室、房部、体部及侧脑室额角的手术操作。结论两种纵裂入路均可在显微镜、内镜下充分显露第三脑室等部分结构,组织创伤小,临床上可根据病变特点和手术需求选择合理的入路方式。

The Structure Characteristics and Anatomical Landmarks Exposure via Different Longitudinal Interhemispheric Approaches under Microscope and Endoscope

Objective To explore the structure characteristics and anatomical landmarks location via different longitudinal interhemispheric approaches under microscope and endoscope. Methods A total of 10 adult head specimens were divided into group A and B with 5 for each. Under microscope and endoscope, the local anatomy and internal structure was observed via anterior interhemispheric approach in group A and via transcallosal choroidal fissure and lateral ventricle keyhole approach in group B. Results The sellar region and the third ventricle were obtained minimally invasive exposure and location, and were beneficial to tumor excision of anterior portion of the third ventricle and sellar region via anterior interhemispheric approach. The anatomical structure of third ventricle and lateral ventricle was achieved minimally invasive exposure and location, and was helpful to operative procedure in third ventricle, atria part, caudomedial part and cornu frontale ventriculi lateralis via transcallosal choroidal fissure and lateral ventricle keyhole approach. Conclusions The two different longitudinal interhemispheric approaches can expose thoroughly the anatomical structure of the third ventricle with mini-tranma. The appropriate surgical approach can be selected according to the pathological features and surgical requirement.