内窥镜下经鼻-蝶窦入路垂体手术的解剖学研究

Anatomical Study on Endoscopic Transnasal Transsphenoidal Approach for Pituitary Surgery

目的 :研究鼻腔、蝶窦、蝶鞍的解剖与内窥镜下垂体手术的关系。方法 :在矢状位上测量32具尸头 ,包括用鼻牵开器测量鼻腔宽度和测量前鼻棘至蝶鞍前壁的长度 ,此外 ,通过内窥镜经鼻腔 -蝶窦入路直接观察 4具尸头的解剖结构。结果 :前鼻棘至蝶窦开口之间的距离 4.6～ 7.0 cm,平均 5 .8cm。蝶窦开口至蝶鞍前壁的距离为 1 .0～ 2 .1 cm,平均 1 .4cm。结论 :内窥镜下经鼻 -蝶窦垂体手术这一入路可以很容易地到达蝶鞍 ,对患者损伤很小 ;但操作空间狭小 ,周围毗邻许多重要解剖结构 ,需要对其解剖进行深入研究 ,并在尸头多加训练 。

Objective:To investigate endoscopic pituitary surgery approach through nasal cavity, sphenoid sinus and sella turcica. Methods:36 cadaver heads were studied. Sagittal sections of 32 cadaveric heads were analyzed, including the width of nasal cavity using nasal retractor and the distance from the anterior nasal spine to the anterior wall of sella. the anatomy of four cadavers were directly observed by endoscopic transnasal transsphenoidal approach. Results:In this procedure,the operating space was narrow (1.2 cm in diameter) and deep;the distance between the anterior nasal spine and the operating of sphenoid sinus was ranged from 4.6 to 7.0 cm, mean was 5.8 cm;the distance between the operaing of sphenoid sinus and the anterior wall of sella was ranged from 1.0 to 2.1 cm,mean was 1.4 cm. Conclusion: Endoscopic thansnasal transphenoidal approach was very easy to reach to the sella and causes minor damage to the patient.It should be paid more attention to for the narrow opearting space and important anatomy structure.