翼点入路神经内镜和显微镜下垂体上动脉的应用解剖学研究

Endoscopic and Microsurgical Anatomy of Superior Hypophyseal Artery through Pterional Approach

目的研究神经内镜和显微镜下垂体上动脉的手术相关解剖。方法在8具(16侧)尸头标本上模拟翼点入路对垂体上动脉在神经内镜和显微镜下进行解剖,观察并测量其数量、管径、起始部位、行程及分布。结果垂体上动脉可分为单干型和多干型;每侧数量为1～4支;起始点距眼动脉起始点在5 mm以内的占87.5%(14/16);发出后向后上内方向走行,多在靠近垂体柄处发出分支。结论本研究为内镜辅助下垂体上动脉瘤夹闭术和鞍区肿瘤切除术中保护垂体上动脉提供了依据。

Objective To study the endoscopic and microsurgical anatomy of the superior hypophyseal artery （SHA） through pterional approach. Methods Eight adult cadaveric heads （16 sides） were dissected under microscope and endoscope through pterional approach. The number, diameter, origin, run and distribution of SHA were observed and measured. Results There were two distinct microsurgical patterns of SHA, i.e. single trunk and multiple trunks. SHA on each side varied in number between one and four. The origins of the arteries was within 5 mm distal to the ophthalmic artery origins in 87.5%（14/16） of the specimens. The arteries ran posterosuperomedially toward the origin of the pituitary stalks and then sent out several branches. Conclusion The present study is helpful to endoscope-assisted clipping of the SHA aneurysm and protecting SHA during the microsurgery for the sellar tumors.