扩大翼点-经颞叶-经天幕入路的显微外科解剖学研究

Microanatomical study of the extended pterional transtemporal transtentorial approach

目的通过对扩大翼点-经颞叶-经天幕入路进行显微外科解剖学研究,为岩斜区肿瘤手术治疗提供解剖学基础。方法在5例(10侧)成人湿性头颅标本上模拟扩大翼点-经颞叶-经天幕入路,并结合10例(20侧)成人头颅干性标本进行颅底骨性结构间距离的测量,显微镜下观察该入路的岩斜区结构显露情况。结果扩大翼点-经颞叶-经天幕入路可充分显露海绵窦、鞍旁以及上、中斜坡等颅底重要结构。结论扩大翼点-经颞叶-经天幕入路适用于向鞍旁和海绵窦方向侵及的岩斜区肿瘤,对于主体位于颅后窝的岩斜区肿瘤同样具有较好的可操作性。

Objective To study the microsurgical anatomy of the extended pterional-transtemporal-transtentorial approach to provide anatomical basis for surgical treatment ofpetroclival tumors. Methods Five adult fresh cadaveric heads （10 sides） were dissected by simulating the extended pterional-transtemporal-transtentorial approach, and the distances between the important bony structures in the skull base were measured in 10 adult dry cadaveric heads （20 sides）. The visual exposure of the structures in the petroclival region was observed under microscope. Results The important structures in the skull base including cavernous sinus, parasellar region, upper- and mid-clivus were exposed in extended pterional-transtemporal-transtentorial approach. Conclusions The extended pterional- transtemporal-transtentorial approach is appropriate for the treatment ofpetroclival tumors invading the cavernous sinus and parasellar region, and also has good maneuverability for the petroclival tumors mainly located in the posterior cranial fossa.