翼点入路不同视角下鞍区常用手术间隙的显微解剖

Microanatomy of operating spaces in sellar region via pterional approach under different visual angle

目的经翼点入路不同视角下对鞍区手术间隙Ⅰ、Ⅱ进行显微解剖学研究,掌握和熟悉手术间隙的界线、大小及不同视角下其内重要结构的可见度及临床意义。方法15例成人湿性头颅标本模拟翼点入路双侧开颅,经手术显微镜沿颅底方向在不同手术视角(0°、30°、45°、60°)下对鞍区手术间隙Ⅰ、Ⅱ进行观测,所得数据用SPSS10.0软件进行统计学分析。结果在不同视角下,描述和测量了间隙Ⅰ、Ⅱ内血管和神经的毗邻、走行、直径和长度。两个间隙沿颅底视角从0°至60°,内侧边、外侧边均逐渐延长,底边逐渐缩短,且在30°视角下面积最大。结论间隙Ⅰ、Ⅱ是鞍区手术中最常用的间隙,在30°视角下,其手术操作空间最大;后交通动脉、颈内动脉末端及基底动脉分叉部在30°视角下显露最充分,最利于手术的进行。

Objective To study operating space Ⅰ and Ⅱ in sellar region under different visual angle, to observe and measure the boundary, area and different content in operating spaces. Methods The anaomy of operating spaces in sellar region via pterional approach was studied in 15 adult cadaver brains under microscope. The observation and measure were under different visual angle. The outcomes were analyzed with SPSS 10.0 software. Results The structures of operating spaces were described and measured under different visual angles. In space Ⅰ and Ⅱ , the medial side and the lateral side were more and more longer and the basal side was more and more shorter under different visual angles from 0° to 60°. The areas of spaces Ⅰand Ⅱ under the angle 30° were the biggest. Conclusion Under the angle 30°, the operative vacuity of space Ⅰ and Ⅱ were the biggest. Posterior communicating artery （PCA）, the extremity of internal cervical artery （ICA）, and the bifurcation of basal artery （BA） were exposed obviously.