前循环动脉瘤经颅手术入路的研究进展

Research progress of transcranial surgical approach for anterior circulation aneurysms

随着神经外科对的手术精确性要求不断提高,精细手术技术不断发展,显微解剖及入路的研究也有了更新的进展,手术入路也有了更多种的选择。前循环动脉瘤不仅具有位置较深、解剖位置复杂的特点,且存在穿支多、血管变异复杂因素,因此较颅内其他部位动脉瘤的手术难度较高。前循环动脉瘤是颅内动脉瘤是高发部位之一,当前对前循环动脉瘤的手术入路选择有了长足的发展。目前常用于处理位于前循环动脉瘤的显微外科手术入路主要有经典的翼点入路、小创面的眶上外侧入路和锁孔入路,以及在此类基础手术入路上发展出来的眉弓锁孔入路、翼点锁孔入路及联合手术入路。本文将对目前常用的前循环动脉瘤经颅手术入路种类和其特点进行综述。

With the increasing requirements of neurosurgical accuracy of surgery and the development of fine surgical techniques,the research of microdissection and approach has also been updated,and there are more options for surgical approaches.Anterior aneurysms not only have the features of deep location,complex anatomical location,multiple perforating branches,complicated blood vessels,etc.,so they are more difficult to operate than aneurysms in other parts of the skull.Because intracranial aneurysms are one of the high-frequency sites,the current surgical approach to anterior circulation aneurysms has made considerable progress.The transcranial surgical approaches currently used to treat anterior circulation aneurysms are mainly divided intopterygium approach,supraorbital lateral approach,and keyhole approach.Based on this,the eyebrow arch keyhole approach and wingpoint keyhole are developed.Approach and combined surgical approach.The types and characteristics of transcranial surgical approaches for anterior circulation aneurysms currently used are reviewed.