经鼻内镜颅底手术解剖数据实时采集的初步研究

Preliminary study on the applied anatomy data collection for the transnasal endoscopic surgery of skull base

目的:探讨MicronTracker双目视觉导航仪在经鼻内镜颅底手术中解剖数据实时采集的可行性;为经鼻内镜颅底手术提供解剖学依据。方法:在MicronTracker双目视觉导航仪的基础上研制成功经鼻内镜手术解剖数据实时采集系统,测量67具(男32具,女35具)干颅骨相关平面及各解剖结构之间的角度和距离,并行统计学处理。结果:①经鼻内镜手术解剖数据实时采集系统运行稳定,可实时读取探针的俯仰角、方向角和针尖所及任意两点的距离。②测得主要解剖标志数据如下:额骨平面与法兰克福平面夹角男女分别为(77.7±4.7)°和(81.6±4.5)°;额骨平面与鼻底平面夹角男女分别为(78.6±5.8)°和(82.0±4.5)°。同侧鼻棘侧缘到破裂孔前缘,俯仰角男女分别为(61.3±7.6)°和(65.6±7.1)°,方向角男女分别为(7.0±2.6)°和(7.1±1.8)°,距离男女分别为(68.9±4.1)mm和(66.3±3.9)mm;同侧鼻棘侧缘到蝶窦开口,俯仰角男女分别为(40.5±9.3)°和(46.4±6.8)°,方向角男女分别为(2.1±1.8)°和(3.6±2.6)°,距离男女分别为(56.2±3.1)mm和(53.4±3.0)mm。结论:①基于MicronTracker双目视觉导航仪的鼻内镜手术实时解剖数据采集系统可实现解剖标志的快速空间定位及记录。②额骨平面和正中矢状面与鼻腔及颅底结构空间关系恒定,可作为确定鼻腔、前颅底解剖标志空间定位的基准平面。

Objective：To explore the feasibility to measure the anatomy landmarks in the anatomy research, even in the operation by the MicronTracker binocular visual navigation system, and to study the anatomy of the transnasal endoscopic surgery of skull base. Method： We designed a new anatomy data collection system based on the MicronTracker binocular visual navigation system to measure and record the anatomy landmarks, and measured the angles and distances between the related planes and the important structures on 67 dry adult cranium specimens （32 male, 35 female）. Result： ①The system is reliable, the angles and the distances can be acquired in the real time. ②The major date of the landmarks was the pitch of the Frankfurt horizontal plane according to the frontal bone plane, male： （77.7±4.7）°, female： （81.6±4.5）°; the pitch of the bony nasal floor according to the frontal bone plane,male： （78.6±5.8）°, female： （82.0±4.5）°; from the same side of nasal spine to the anterior edge of foramen lacerum, pitch, male： （61.3±7.6）°, female： （65.6±7.1）°, azimuth, male： （7.0±2.6）°, female： （7.1±1.8）°, the distance： male： （68.9±4.1）mm, famle： （66.3±3.9）mm; from the same side of the nasal spine to the aperture of the sphenoidal sinus, pitch, male： （40.5±9.3）°, female.. （46.4±6.8）°, azimuth, male： （2.1±1.8）°, female： （3.6±2.6）°, the distance, male： （56.2±3. 1）mm, female： （53.4±3.0）mm. Conclusion： ①The anatomy data collection system based on the MicronTracker binocular visual navigation system can be used to measure the anatomy landmarks conveniently, accurately and quickly. ②The relationship between the landmarks of the skull base and the nasal cavity and the frontal bone plane and the sagittal plane is stable, and the planes can be used as the datum plane to look for the landmarks in the transnasal endoscopic surgery of skull base.