内镜下扩大经鼻蝶入路海绵窦的解剖研究  

Anatomic study of the extended endoscopic endonasal transsphenoidal approach to the cavernous sinus

作　　者：战祥新 滕文荃 宋明[2] 孙炜[3] 张亚卓[4] 

机构地区：[1]山东省莒县中医医院神经外科,日照276500 [2]北京三博脑科医院外七科,100093 [3]中国康复中心北京博爱医院神经外科,100068 [4]北京市神经外科研究所,100050

出　　处：《中国微侵袭神经外科杂志》2012年第10期464-466,共3页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的通过内镜下扩大经鼻蝶入路海绵窦的解剖学研究,为海绵窦病变手术入路的选择提供解剖学依据。方法在10例成人头颅标本上模拟3种扩大经鼻蝶入路即鼻中隔旁入路、中鼻甲切除入路、中鼻道入路,观察各手术入路重要的解剖标志和显露范围。结果蝶窦开口、斜坡凹陷、颈内动脉隆起、视神经隆起、颈内动脉-视神经隐窝、翼管等为重要的手术标志。颈内动脉海绵窦段双弯曲型18侧,不典型弯曲型2侧。结论内镜下扩大经鼻蝶入路是海绵窦病变的重要入路。Objective To study anatomy of the expanded endoscopic endonasal transsphenoidal （EEET） approach to the cavernous sinus in order to provide anatomical basis for the choice of surgical approaches for cavernous sinus lesions. Methods Ten adult cadaveric heads were dissected by simulating 3 kinds of the EEET approach including paraseptal, middle meatal, middle turbinectomy approaches. The important anatomical landmark and exposure range of each approach were observed. Results The sphenoid sinus opening, clivus recess, internal carotid artery protuberance, optic nerve protuberance, internal carotid artery-optic nerve recess and pterygoid canal are important surgical signs. Double curved type of intracavemous internal carotid artery is found in 18 sides and atypical curved type in 2 sides. Conclusions EEET approach is one of the important surgical approaches.

关 键 词：神经解剖学 入路 扩大经鼻蝶 神经内镜 海绵窦 

分 类 号：R323.1[医药卫生—人体解剖和组织胚胎学]