经胼胝体前部入路的侧脑室和第三脑室显微和内镜解剖研究

Study of anatomy related to microsurgery and neuroendoscope-assisted surgery through anterior callosal corpus approach

目的探讨经胼胝体前部入路侧脑室和第三脑室显微镜和内镜解剖特点,为微创切除侧脑室和第三脑室病变减少并发症、提高手术效果提供解剖学依据。方法应用5具新鲜尸头模拟经胼胝体前部入路,在显微镜及神经内镜下观察侧脑室及第三脑室的重要解剖标志及其毗邻关系,测量重要解剖标志的间距。结果显微镜下侧脑室内可观察到脉络丛、隔静脉、丘纹静脉、室间孔、透明隔,内镜可进一步观察部分额角、枕角及三角区;神经内镜下第三脑室底壁从前向后依次可见视交叉、漏斗隐窝、灰结节、乳头体和中脑导水管。结论经胼胝体前部入路手术,通过颅内自然裂隙进入,直视下操作,解剖标志清楚;神经内镜辅助显微镜,可进一步扩大视野,减少对周围重要结构损伤;熟悉该入路的解剖标志及相关解剖有助于提高手术效果。

Objective To provide the anatomic base for microsurgery and neuroendoscope-assited surgery through the anterior callosal corpus approach to the lateral ventricle and third ventricle.Methods The microsurgery and neuroendoscope-assited surgery through the anterior callosal corpus approach to the lateral ventricles and third ventricles were simulated in 5 fresh cadaveric heads.The structural features in the lateral ventricles and third ventricles and adjacent relationship among them were observed.Results The choroid plexus,septal vein,terminal vein,interventricular foramen,septum pellucidum were observed under the microscope.The frontal horn,occipital horn and triangle region in the lateral ventricle were observed by the neuroendoscope.The optic chiasm,funnel crypt,gray tubercle,mamillary body and the cerebral aqueduct in the bottrom of the third ventricle were observed in anterioposterior order.Conclusions The anatomic landmarks related to microsurgery and neuroendoscope-assited surgery through the anterior callosal corpus approach can be clearly observed in the lateral and third ventricles.Understanding of these anatomic landmarks and relevant anatomical data is very helpful to removal of the lesions in the lateral and third ventricles by microsurgery and neuroendoscope-assited surgery through the anterior callosal corpus approach.