经眉弓切口锁孔手术切除鞍区病变的解剖及临床应用研究

报道经眉弓切口锁孔入路切除鞍区肿瘤的应用解剖及临床手术经验。方法：取成入干性颅骨标本30侧，福尔马林固定的成人尸体头部标本5例，测量与经眉弓锁孔入路相关的数值，模拟手术过程，临床32例鞍区肿瘤经该入路行手术切除。结果：颅骨相关部位测量结果表明，眶上孔及额窦位置的变异与手术相关，在尸体标本上显微镜和内窥镜下模拟手术入路，可暴露鞍区四个间隙及相关结构。临床32例鞍区肿瘤经此入路手术，效果满意，肿瘤全切17例(53．12％)，无重大并发症。结论：经眉弓切口锁孔入路切除鞍区病变是完全可行的，可取得与经额下入路和翼点入路相似的暴露效果，且能克服其他入路存在的某些缺陷。

Resection of sellar area tumor via transeyebrow keyhole approach: anatomic and clinical study

Objective: To evaluate the possibility and gain surgical experiences of the operation of sellar area tumor via eyebrow incision and keyhole approach. Methods: 15 human adult skulls and 5 formalin-fixed human cadaver heads were used to do measurements related to transeyebrow keyhole approach and to imitate the procedure of operation. Clinical operations were carried out on 32 patients with sellar area tumors. Results: Skull measurement demonstrated that the position of supraorbital foramen and frontal sinus would affect transeyebrow keyhole craniotomy. 4 spaces of sellar area could be viewed and controlled under microscope and endoscope. 32 patients operated via this approach got good results. Total resections were gained in 17 patients (53.12%). No approach-related complication was observed. Conclusion: Removal of the sellar area tumors via transeyebrow keyhole approach is absolutely practicable. It is as effective as traditional subfrontal or pterional approach, but with less trauma to the patients.