内镜下眶上硬膜外入路海绵窦区显微解剖学研究

Microanatomic study on supraorbital extradural approach to cavernous sinus under endoscope

目的探讨内镜下眶上硬膜外入路海绵窦区的显露范围及显微解剖结构,为临床神经外科提供解剖学依据。方法对20具新鲜尸头使用4 mm 0°、30°内镜观察,鉴别与入路有关的解剖标志。结果内镜下眶上硬膜外入路可分为3个步骤:内镜进入前颅窝底、内镜进一步进入中颅窝及眶骨膜、内镜下暴露海绵窦上壁及外侧壁。该入路内镜下可以清晰地暴露海绵窦侧壁显微解剖,尤其是Dolence三角、Parkinson三角和Mullan三角。结论内镜下眶上硬膜外入路可以通过微侵袭手段较好地显示海绵窦区显微解剖,是一种值得推广的手术方法。

Objective To investigate the microanatomic and surgical exposure of supraorbital extradural approach to cavernous sinus under endoscope, so as to provide the microanatomic basis for clinical neurosurgery. Methods Twenty fresh cadaver heads were studied using 4 mm 0° and 30° endoscopes to develop a surgical approach and identify surgical landmarks. Results The endoscopic supraobital extradural approach could be divided into 3 stages： entry into the extradural anterior cranial fossa, exposure of the middle cranial fossa and periorbita, and exposure of the superior and lateral cavernous sinus. This approach could expose superb views of the cavernous sinus microanatomy especially through the Dolence triangle, Parkinson triangle and Mullan triangle. Conclusion Endoscopic supraobital extradural approach offers excellent microanatomy of the cavernous sinus with minimal invasiveness, which is worthy of introduction.