经枕小脑幕锁孔入路松果体区的应用显微解剖

Microsurgical anatomy of the pineal region using keyhole operation via the suboccipital-transtentorial

目的探讨开展松果体区病变锁孔手术的可行性。方法应用显微外科解剖学技术,对经甲醛固定、动静脉血管内分别灌注红、蓝乳胶的10具成人尸头标本,按手术入路逐层解剖。观察手术径路中环池、四叠体池、胼胝体压部、三脑室后部、大脑大静脉系统、松果体、四叠体的显露范围。结果经枕小脑幕锁孔手术入路对松果体区的显露满意,有充足的手术操作空间,而无效脑暴露少,对脑组织的牵拉损伤小。结论经枕小脑幕锁孔手术入路行松果体区手术是可行的。

Objective To study the microsurgical anatomy of the pineal region using suboccipital-transtentorial keyhole operation approach. Methods Ten cadaveric heads fixed with formalin and with their arteries and veins perfused using red or blue color latex were dissected with microsurgical anatomical skills. The cisterna ambiens, cisterna corporaquadrigemina, corpus callosum, posterior of the third ventricle, system of Galen veins, pineal gland and corpora quadrigemina were observed. Results The exposure of the pineal region in both of the suboccipital-transtentorial keyhole approach and the common suboccipital-transtentorial approach was the same. But the useless exposure of the brain and the injury of the tissue was less during the first approach than the latter one. Conclusion The operation of the pineal region is feasible via the suboccipital-transtentorial key hole operation approach.