经鼻-蝶窦入路至鞍区内镜解剖与显微解剖的比较研究

Comparison of endoscopic surgery and microsurgery via endonasal transsphenoidal approach to the sellar region:an anatomic research

目的为比较内镜下与显微镜下经鼻-蝶窦入路的解剖标志和显露范围差异。方法对9例汉族成人灌注尸头采用经鼻-蝶窦入路进行解剖,其中4例行显微解剖,5例采用内镜下解剖,在内镜与显微镜下分别对入路的解剖标志和显露范围进行比较。结果在蝶窦内,内镜下可以观察到更多的解剖标志以确定鞍底、海绵窦等重要结构的位置;内镜经鼻-蝶窦入路更易于向颅前窝底、鞍旁海绵窦和斜坡方向扩展。内镜与显微镜下的操作存在较大差异。结论内镜经鼻-蝶窦入路鞍区及其周围的显露范围较显微镜下更大。

Objective To compare differences in the anatomic landmark and exposure of the surgical field between microscopic endoscopic endonasal transsphenoidal approaches. Methods The dissection study was performed via transsphenoidal approach in 9 adult cadaveric heads; 5 heads were dissected with endoscope, and the other 4 with microscope. The anatomic structures and extent of exposure were observed and compared between the two groups. Results In sphenoid sinus, more structures can be observed under endoscope through transsphenoidal approach, It is easier with endoscope than with microscope to extend the approach to expose anterior skull base, parasellar region and clivus region. Conclusion Compared with the exposure under microscope, endoscopic endonasal transsphenoidal approach can provide wider operative space and clearer vision.