垂体上动脉显微外科解剖学研究

The microsurgical anatomy of superior hypophyseal artery

目的 了解垂体上动脉的起始、行程、分布和变异 ,为鞍区肿瘤手术时保护垂体上动脉以及为垂体上动脉瘤与床突旁其他类型动脉瘤区别提供依据。方法 5 0具成人尸体头颅垂体上动脉标本 ,在解剖显微镜下解剖和分析。结果 垂体上动脉为一组血管丛 ,分 1～ 4支 ,起始于颈内动脉内侧 ,平均直径 0 2 2mm ,起始部距眼动脉起始部小于 5mm者占 82 % ,二种分支类型 :粗大支型占45 % ,呈烛台式供应垂体柄、视神经和视交叉 ,平均直径为 0 30mm ,3～ 4支型占 5 5 %。

Objective To inform the origin, course, distribution and variation of superior hypophyseal artery, in order to provide its anatomical basis for protecting and differentiating between superior hypophyseal artery aneurysms and paraclinoidal carotid artery aneurysms. Methods 50 adult cadaver brains include superior hypophyseal artery were dissected in detail under anatomical microscope. Results The superior hypophyseal artery was a complex of vessels that can be varied in number from one to four. Superior hypophyseal arteries arised from the medial aspect of the proximal internal carotid with an average diameter of 022mm. The origin of superior hypophyseal arteries was within 5mm of the opthalmic artery origin in 85% of the specimens. There were two distinct patterns in superior hypophyseal artery anatomy. In 45% cases, a large, dominant stem of superior hypophyseal artery like a candelabra with small branches to pituitary stalk, optic nerve and chiasm. The average diameter of the larger branches was 030mm, while in the left 55% cases, three or four medial vessels were found. Conclusion The microanatomical data of the superior hypophyseal artery is benefit for saving vision during sellar tumor operation and for differentiating the superior hypophyseal artery aneurysms and paraclinoidal carotid artery aneurysms.