经穹窿间中间帆入路解剖研究与临床应用

Anatomical studies of interforniceal interpositum approach and its clinical application

目的研究经穹窿间中间帆入路的手术显露,并探索临床应用疗效。方法导航辅助下在16具尸体头颅标本上模拟经穹窿间中间帆入路手术,显微镜下观察分析第三脑室、松果体区的显露。选择6例松果体区、第三脑室肿瘤患者行经穹窿间中间帆入路手术治疗。结果导航辅助下经穹窿间中间帆入路手术能在标本头颅上顺利完成,可清晰显露第三脑室后部及松果体区。6例松果体区、第三脑室肿瘤全切5例、次全切除1例,无新神经功能损害及死亡发生。结论经穹窿间中间帆入路手术治疗松果体区、第三脑室肿瘤技术上可行,临床应用效果良好。

Objective To probe into the feasibility and clinical application of interforniceal interpositum approach. Methods The simulated operations of interforniceal interpositum approach were performed in 16 eadaveric heads with bone window 2 -4 cm front to coronal suture with the assistance of Stryker neuronavigation system. The operation exposure of third ventricle and pineal region was investigated and analyzed. Soon afterwards, operations of interforniceal interpositum approach were successfully performed in 6 patients with the tumors in pineal region and third ventricle. Results The operations of interforniceal interpositum approach could be successfully accomplished in cadaveric heads with the assistance of Stryker neuronavigation system. Pineal region and the posterior third ventricle could be clearly exposed in the keyhole approach. Of the 6 clinical cases, 5 were totally removed and 1 was subtotally resected. There was not new neurological impairment or death. Conclusion Interforniceal interpositum approach is feasible for the tumors in pineal region and third ventricle, with satisfactory effects in clinical application.