经眶额颞入路鞍区手术间隙的应用解剖

目的研究眶额颞入路中鞍区4个手术间隙的显微解剖特征,探讨这些间隙在鞍区显微外科手术中的应用。方法在10例(20侧)成人尸头标本上,模拟眶额颞入路开颅,在显微镜下对鞍区手术常用的4个手术间隙及其内部结构进行解剖观察和测量。结果对视交叉前间隙、视神经-颈内动脉间隙、颈内动脉-小脑幕三角间隙及终板间隙的结构构成及其邻近血管神经进行描述测量。结论选择合适的手术入路、熟悉鞍区解剖间隙的显微解剖、保护穿通支是鞍区手术成功的关键。眶额颞入路兼有额下和翼点入路的优点,适合大型鞍区肿瘤的切除。

Applied anatomic research for surgical spaces of sellar region via transorbital-subfrontal-temporal approach

Objective To study the microanatomical feature of four surgical spaces in sellar region via transorbital-subfrontal-temporal approach and find out the application of these spaces in clinical microsurgical operation.Methods Microsurgical anatomy of four surgical spaces in sellar region via transorbital-subfrontal-temporal approach were observed and measured on 10(20 sides) adult cadaveric head specimens under operative microscope.Results The structures of prechiasmatic cistern triangle,optico-cartid triangle,carotido-tentorial triangle and chiasmatic-terminal lamina triangle were described and measured.Conclusion To select the suitable approach and understand the microsurgical anatomy of the operating spaces in sellar region and protect the perforationg branches are the key during the operation.Transorbital-subfrontal-temporal approach has some advantages over transpterional approach and transfrontal approach to some larger tumors in sellar region.