经锁孔入后交通动脉神经内镜应用解剖学研究

Neuroendoscopy application to anatomic study of posterior communicating artery through key-hole approaches

目的 该研究的目的是经三种不同的锁孔入路观察后交通动脉 ,探讨神经内镜的应用价值。方法 在 6具尸头上 ,经翼点锁孔入路、颞下锁孔入路、耳后锁孔入路用手术显微镜、神经内镜观察后交通动脉 ,记录其起点、行程和分支。在 11例开颅手术中观察了后交通动脉。结果 每一支颈内动脉均发出后交通动脉 ,其起点多位于颈内动脉后壁或后内侧壁 ,后交通动脉发出 2～ 8支穿通支 ,向内上方行走 ,供应三脑室底部、视神经和视交叉。经过不同的锁孔入路对后交通动脉的观察的结果不同。结论 后交通动脉是鞍区一支重要的动脉 ,与鞍区手术有密切的关系。

Objective:To observe PcoA through microscope and endoscope in different keyhole approach and to explore the applied value of Neuro-endoscope.Methods:PcoA of 6 cadaver heads were observed through pterional, subtemple and retrosigmoid keyhole approaches under the micrescope and the endoscope. The origin , course,branches of PcoA were recorded after the obseroation. PcoA were also investigated in 11 operations.Results: Every ICA had its PcoA.They arose from the posterior or lateral posterior wall of ICA.Every PcoA had 2～8 perforating branches that ran medially to supply the floor of third ventricle, optical nerve and optical chiasm. The results is different when different key-hole approaches were used to observe PcoA.Conclusions:PcoA is an important artery in the sella region. Neuro-endoscope is useful to the operations in this region.It had great value in t he observation during operation and the protection of PcoA.