虚拟现实技术量化比较Kawase和乙状窦前入路显露上斜坡的显微解剖

Quantitative comparison of Kawase versus presigmoidal approach exposing upper clivus by virtual reality skill

目的在虚拟现实影像模型中评估Kawase入路和乙状窦前入路显露上斜坡的解剖差别。方法对15例尸头进行CT和MRI扫描,影像数据输入虚拟现实系统构建颅后窝三维解剖模型。在颅盖和颅底骨性结构中选取标志点勾勒Kawase入路和乙状窦前入路显露上斜坡的手术路径。测量解剖结构体积,比较两种手术路径的显露特征。结果两种入路通过磨除岩骨到达上斜坡,乙状窦前入路手术路径、路径中包含骨性结构和静脉结构的体积均多于Kawase入路,Kawase入路中包含脑神经体积多于乙状窦前入路,差异均有统计学意义(P<0.05)。结论比较Kawase入路和乙状窦前入路显露上斜坡的解剖特征有助于指导选择合适的手术入路。

Objective To compare the anatomic difference of Kawase versus presigmoidal approach exposing the upper clivus based on virtual reality image model.Methods CT and MRI scans were performed in 15 adult cadaver heads.Image data were inputted into virtual reality system to build three-dimensional anatomy model of posterior cranial fossa.Kawase and presigmoidal approaches exposing the upper clivus were outlined by selecting osseous landmark points on the calvaria and skull base.Volumes of tissues were measured.Characteristics of the two approaches were compared.Results Both two approaches reached the upper clivus by drilling petrous bone.The volumes of surgical route,osseous and venous structures in presigmoidal approach were more than those in Kawase approach,while the volume of cranial nerve involved in Kawase approach was more than that in presigmoidal approach,and all the differences showed statistical significance（P〈 0.05）.Conclusion Comparison of Kawase approach versus presigmoidal approach exposing the upper clivus can be used to guide selection of suitable approaches.