颞下锁孔入路的内镜解剖学研究

目的研究颞下锁孔入路的内镜解剖学特点,指导临床手术。方法 8例成人尸头,取颞下锁孔入路,在内镜下观察小脑幕中切迹的解剖结构,并测量之,同时了解其与毗邻结构的关系。结果颧弓后根前1/3处颅骨内板至脑干和小脑幕游离缘的距离分别为(47.30±3.82)mm和(39.79±3.06)mm,通过内镜能够观察到鞍后、脚间池、岩斜区和小脑幕游离缘周围的神经和血管结构。结论颞下锁孔入路具有骨窗小,但显露充分,手术创伤小的特点,可处理小脑幕游离缘为中心的病变,熟悉入路中各结构间的相互位置关系和距离对术中定位有很大的帮助。

Study of anatomy related to endoscope-assisted neurosurgery through subtemporal keyhole approach

Objective To study the anatomy related to endoscope-assisted neurosurgery though the subtemporal keyhole heads.The structures around the middle tentorial incisure and the relationship among them were observed and measured under the endoscope.Results The distances from the zygomatic arch to the brain stem and to the free edge of the tentorial incisures were （47.30± 3.82）mm and （39.79±3.06）mm respectively.With the help of endoscope,the postsellar region,interpeduncular cistern,petroclival region and nerves and vessels around the middle tentorial incisures could be observed.Conclusions The lesions around the middle tentorial incisures can be removed by the endoscope-assisted neurosurgery though the subtemporal keyhole approach.Understanding the relationship among the structures related to the subtemtoral keyhole approach is very helpful to the intraoperative location of the lesions.