神经内镜下经纵裂胼胝体侧脑室入路的应用解剖

目的　为临床开展神经内镜下经纵裂胼胝体侧脑室入路到达侧脑室及第三脑室手术提供应用解剖学基础。 方法　对10例成人尸头标本经纵裂胼胝体前部侧脑室入路在神经内镜下观察侧脑室、第三脑室结构并测量数据。 结果　（1）胼胝体厚度(6.1±1.2)mm,室间孔长、宽径为(5.6±1.4)mm、(3.0±　1.6)mm,中间块长、宽径（6.3±1.8）mm、（3.4±1.2）mm;（2）冠状缝前5cm引流静脉很少;（3）神经内镜观察侧脑室前角、侧脑室体部及室间孔的Y形结构,且可以通过室间孔进入第三脑室,进行较好的暴露和观察;（4）胼胝体切开1.5 cm,硬质内镜操作空间和观察范围受限,胼胝体切开2.0 cm时,适合神经内镜操作和观察。 结论　经纵裂胼胝体前部侧脑室入路按生理间隙进入,操作距离短,内镜直接指向室间孔,可同时显露对侧脑室,是处理双侧脑室、室间孔区及第三脑室病变的理想入路。

Lateral ventricular neuroendoscopic anatomy through the interhemispheric transcorpus callosal approach

Objective　To provide anatomical basis for lateral ventricular neuroendoscopic surgery through the interhemispheric transcorpus callosal approach.　Methods　The anatomic investigation of the lateral and third ventricle was performed in 10 adult cadaveric head specimens, through interhemispheric transcorpus callosal approach.　Results　The thickness of corpus callosum was (6.1±1.2) mm, the sagittal and transverse diameters of interventricular foreman (5.6±1.4) mm and (3.0±1.6) mm, and the sagittal and transverse diameters of interthalamic adhesion (6.3±1.8) mm and (3.4±1.2) mm. There were very less drainage veins to the sagittal sinus anterior to the coronal suture. The body and front horn of the lateral ventricle, the "Y" shape structure of interventricular foreman could be observed under different angular neuroendoscope. Cut size of 2 cm on corpus callosum than that of 1.5 cm was better to reveal the structures and exert operation under a rigid endoscopic surgery.　Conclusions　Interhemispheric transcorpus callosal approach is a safe and valuable way to treat affection in double lateral ventricle, area of interventricular foreman and the third ventricle.