扩大经鼻蝶入路海绵窦的内镜解剖研究

目的通过对扩大经鼻蝶窦入路的内镜解剖学研究,为临床应用提供形态学基础.方法在10具动脉灌注染料的成人尸头上模拟扩大经鼻蝶窦手术入路,测量海绵窦内重要结构与鞍底的距离.结果扩大经鼻蝶手术入路可清晰显示鞍底的骨膜、硬脑膜外层、海绵窦内侧壁,及海绵窦内的颈内动脉及其分支血管、动眼神经、滑车神经、展神经及视神经等结构.结论内镜下行扩大经鼻蝶手术入路可清晰显露海绵窦及其内的解剖结构,适用于鞍内病变侵犯海绵窦的外科治疗.

The endoscopic cavernous sinus surgery via the extended transsphenoidal approach:an anatomic study

Objective The endoscopic surgical anatomy of the cavernous sinus via the extended transsphenoidal approach was studied to establish an anatomic basis for surgical treatment. Methods Simulated surgery was performed on ten adult cadaver heads via extended transsphenoidal approach and some anatomic parameters were measured. Results The following anatomical structures can be clearly visualized via an extended transsphenoidal approach: the periosteum, the outer surface of the dura, the inside wall of the carotid artery, the internal carotid artery and its branches, oculomotor, trochlear, abducent and optic nerves in the cavernous sinus. Conclusion The endoscopic surgical anatomy of the cavernous sinus can be visualized well via extended transsphenoidal approach. This finding provides a rational surgery approach for the invasion of the cavernous sinus by sellar tumor.