眶尖区经颅前侧方手术入路相关的显微解剖和影像学研究

The study on the microsurgical anatomy of the transcranial anterolateral approach to the orbital apex region

目的 对眶尖区经颅前侧方手术入路相关结构进行显微外科解剖学和影像学研究,为手术入路的研究提供解剖学和影像学数据。方法 利用10例经福尔马林固定的国人成人尸头共20侧,15例头颅干标本共30侧,对眶尖区前侧方手术入路相关解剖标志进行了详细地显微解剖、观察、拍摄、测量和统计。成人尸头行头颅CT三维断层扫描+颅底重建。结果 经颅手术入路相关骨性标志的解剖测量与影像测量距离的均数差值在0.10～4.45mm之间,两组间无统计学差异(P>0.05);解剖和影像测量前床突两者的长、宽、厚,均数差值在0.02～0.51mm之间,两组间也无统计学差异(P>0.05)。结论 解剖测量与影像测量的数值非常接近,影像测量对观察某一部位及其病变、选择手术入路有重要临床意义。但目前存在许多未明确之处,现阶段的测量值只能为临床医师进行手术及相关研究提供一定的参考。

Objective To study the microsurgical anatomy and imaging of the transcranial anterolateral approach to the orbital apex region, and provide anatomical and imaging data for operative approach Methods Ten cases (20 sides) of Chinese adult cadaver heads fixed by 10% formalin and fifteen cases (30 sides) of dry skull samples were studied The relative anatomical landmarks of the transcranial anterolateral approach to the orbital apex region were dissected under microscope, observed, photographed, measured and analyzed The adult cadaver heads were given three dimensional CT scanning, and the images of the skull bases were reconstructed Results The distances between the relative anatomical landmarks of the transcranial anterolateral approach to the orbital apex region were measured by two ways -anatomical and imaging, the mean difference of which was 010~445 mm There was no statistical significance between the two ways(P>0.05) The length, width and height of the anterior clinoid process were measured by the two ways, the mean difference of which was 002~051 mm There was no statistical significance between the two ways(P>0.05) Conclusion The values from the imaging measurements are close to those from the anatomic measurements So the imaging measurements are important for observing the lesion's loci and choosing the operative approaches However, because of many unclear points, the present measuring data only provide some references for the clinicians to carry out the relative operations and studies