经蝶窦入路颈内动脉海绵窦段的内镜解剖学研究

目的研究经蝶窦入路颈内动脉海绵窦段的内镜解剖学特点。方法在11具动脉灌注染料的成人新鲜尸头上模拟扩大经蝶窦手术入路,在内镜下观察颈内动脉海绵窦段的走行特点及颈内动脉海绵窦段分支情况。结果颈内动脉海绵窦段分为5段——后垂直段、后曲、水平段、前曲和前垂直段,有3个动脉分支——脑膜垂体干、海绵窦下动脉和McConnell背囊动脉,其在蝶窦外侧壁上形成颈内动脉隆突,与视神经隆突形成视神经-颈动脉隐窝,是内镜手术中确定颈内动脉及视神经的标志。结论颈内动脉海绵窦段是扩大经蝶窦手术入路中最重要的解剖结构。内镜下扩大经蝶窦手术可清晰显示海绵窦内的颈内动脉及其分支血管和神经等重要的组织结构,是处理海绵窦内侧壁病变的良好手术方式。了解颈内动脉相关解剖对临床手术具有重要的参考价值。

Endoscopic anatomy of the cavernous segment of the internal carotid artery

OBJECTIVE To study anatomical features of the cavernous segment of the internal carotid artery(ICA)via the extended transsphenoid approach under endoscope.METHODS Extended transsphenoid approach was performed on 11 adult cadaver heads.The appearance features of the cavernous segment of the ICA and its vessel branches were observed under endoscope.RESULTS The cavernous segment of the ICA can be divided into 5 segments and has 3 vessel branches.The optico-carotid recess is the landmark to define the ICA and o...