蝶鞍区塑化薄片断层解剖学研究

3D THIN SECTIONAL ANATOMY OF SELLA TURCICA REGION WITH PLASTINATION

为了给临床蝶鞍区手术提供详细的解剖学资料，用中年男性标本３０例，采用Ｐｌａｓｔｉｎａｔｉｏｎ技术，分别作成蝶鞍区连续横、矢、冠状薄片断层标本，进行解剖学观测。结果显示：垂体的左右径大于前后径或上下径，对于垂体病变，宜进行三方位的对照观察，以了解垂体的形态变化。展神经与海绵窦外侧壁之间有间隙存在，说明展神经并不走行于外侧壁中，而是位于海绵窦内。紧贴视交叉的外侧，颈内动脉由海绵窦段的前升部穿过鞍膈移行为床突上段，此处为两侧颈内动脉相距最近点，其间距仅为１１．５ｍｍ。在经额经视交叉下入路的垂体手术时，应注意到这一毗邻关系，以免造成此处颈内动脉损伤。海绵窦外侧壁的手术入路除Ｐａｒｋｉｎｓｏｎ三角外，在其前半部，尚有眼神经与上颌神经之间的间隙；在其中部。

To provide a detail anatomical data for surgeons,the structures of the sella turcica region of the skull base from 30 adult male cadavers were observed and measured on the 3D serial thin sections made by plastination technique. The diameter of the hypophysis from left to right was longer than that from anterior to posterior or from superior to inferior.To demonstrate the pathological changes of the hypophysis,3D observation was recommended.The abducent nerve was found in the cavernous sinus but not in its lateral wall.Because there was a space between this nerve and the laternl wall of the cavernous sinus in the subjects investigated.The anterior ascending portion of the cavernous segment of the internal carotid artery emerged through the diaphragma sellae and turns up as the superior clinoid segment.The site where the artery pirces the diaphragma sellae just lateral to the optic chiasma was at a distance of nearest point of both side artery(11 5mm).This situation should be mentioned in the hypophysis operation approached by the suboptic chiasma to prevent the internal carotid artery from injury at this site. Apart from Parkinsons triangle,there were some spaces on the lateral wall of the cavernous sinus could be as operating approaches.They were the space between the ophthalmic nerve and the maxillary nerve in the anterior portion of the wall,and the space between the oculomotor nerve and the trochlear nerve in the middle portion of the wall.