论文部分内容阅读
目的 为进一步推广和提高内窥镜下经鼻腔 蝶窦入路提供帮助。方法 采用解剖尸头直接观察和内窥镜下测量距离 ,结合活体的CT、MRI图像上观察及测量的方法 ,对 15例 30侧尸头、 10 0侧CT片和 10 0例MRI片的手术入路相关解剖学特点和解剖距离进行研究。结果 全鞍型蝶窦占 82 % ,2 9%合并枕骨气化 ,蝶上筛房出现率为 11% ;前鼻棘至蝶窦口的距离为 6 0 39± 5 38mm ;前鼻棘至鞍底距离为 75 47± 6 36mm ;视神经管多位于蝶窦口侧上方、蝶筛交界处 ,蝶窦口至视神经管的最短距离为 11 0 9± 1 48mm。颈内动脉多位于蝶窦口的后外上方 ,蝶窦口至颈内动脉的最短距离为17 14± 1 6 3mm。结论 内窥镜技术适合于经鼻腔蝶窦入路切除鞍区肿瘤 ;术前的影像学检查、对于手术相关的解剖学结构的认识及熟练的窥镜手术操作技能是保证手术成功的关键因素。
Objective To provide further assistance for the further promotion and improvement of endoscopic transnasal sphenoid approach. Methods A total of 15 cadaveric heads, 100 CT scans, and 100 MRIs were performed on the basis of direct observation of the anatomical cadaver head and distance measurement under endoscope, combined with observation and measurement of living body on CT and MRI images. The anatomical features and anatomical distances of the approach were studied. Results Total sphenoid sinuses accounted for 82%, 29% with occipital gasification, and 11% in the upper ethmoid sulcus; the distance from the anterior nasal sinus to the sphenoid sinus ostium was 6 0 39 ± 5 38mm; the anterior nasal spine to the saddle The bottom distance was 75 47 ± 6 36 mm. The optic nerve tube was located at the upper side of the sphenoid sinus ostium and the junction of the butterfly screen. The shortest distance from the sphenoid sinus ostium to the optic canal was 11 0 9 ± 1 48 mm. The internal carotid arteries were mostly located posterolaterally above the sphenoid sinus ostium, and the shortest distance from the sphenoid sinus ostium to the internal carotid artery was 17 14 ± 163 mm. Conclusion Endoscopic techniques are suitable for transnasal sphenoid sinus surgery for resection of sellar tumors. Preoperative imaging examinations, understanding of the anatomical structures associated with surgery, and skillful speculum operation skills are the key factors for successful operation.