经鼻内镜颅底手术的常用路径及解剖学标志

Main Approaches and Anatomic Landmarks of Transnasal Endoscopic Surgery for Skull Base

目的：探讨鼻内镜颅底手术适应范围、常用路径及其解剖标志。方法：复习相关文献，对经鼻内镜颅底手术各种入路及相关解剖标志的研究成果加以分析、总结。结果：鼻内镜颅底手术常用入路有经鼻中隔旁入路、经中鼻道入路及经中鼻甲切除入路3种，人路涉及的重要解剖学标志有筛前动脉、筛后动脉、中鼻甲、筛窦、蝶骨翼突、蝶筛隐窝、视神经－颈内静脉隐窝及球形鞍底。结论：熟练掌握鼻内镜颅底常用路径及其解剖标志，能够提高手术质量，减少并发症的发生。

Objective： To discuss the main approaches and anatomic landmarks of transnasal endoscopic surgery for skull base area. Methods ：To analyze the research results of various approaches and anatomic landmarks of endoscopic surgery by reviewing relevant articles. Results： The approaches of transnasal eadoscopic surgery for skull base are next to nasal septum, middle nasal meatus and resection of middle nasal concha. The significant anatomy sign on approaches include anterior ethmoidal artery, posterior ethmoidal artery, middle con- cha, antrum ethmoidale, descending lamina of sphenoid bone, recessus sphenoeth moidalis, optic nerve - jugular. Conclusions：Mastering the main approaches and anatomic landmarks of the transnasal endoscopic surgery for the skull - base area is the key point to improve the quality of operations and reduce the incidence of different complications.