幕下小脑上锁孔入路的显微解剖学

Microsurgical anatomic study on infratentorial supracerebellar keyhole approach

目的研究幕下小脑上锁孔入路的显微解剖和应用技术。方法神经导航辅助下完成尸头模拟幕下小脑上锁孔入路手术16例,测量并分析解剖学数据。结果小脑天幕面桥静脉对幕下小脑上锁孔入路无影响;Galen静脉系统可被安全解剖;幕下小脑上锁孔手术能充分暴露松果体区的Galen静脉系统、松果体、四叠体等;可经帆间池进入第三脑室;天幕切开能增加向上向前的手术范围。结论幕下小脑上锁孔入路能充分暴露松果体区,为该区域手术的一种有效的微创入路。

Objective To study the topography and microanatomy technique of infratentorial supraeerebellar keyhole approach. Methods Infratentorial supraeerebellar keyhole approach was applied in 16 eadaverie heads. The data about anatomy,measured by Stryker navigation,were analyzed with SPSS. Results Tentorial bridging veins of the cerebellum had less interference with the keyhole approach. Galen vein and its tributary could be dissected in security. With this approach, the anatomic structures in the pineal region could be exposed and easy to enter the third ventricle. The operation area could be amplified upward and forward by splitting the tentorium. Conclusion The sturetures in the pineal region can be exposed entirely with infratentorial supraeerebellar keyhole approach, which could be used as a minimally invasive approach in the pineal region.