内镜经眉弓上锁孔入路的解剖学研究  

Anatomical study of endoscopic trans-supraorbital keyhole approach

作　　者：武平华[1] 莫立根[1] 陈海南[1] 郭方舟 穆军博 Wu Pinghua;Mo Ligen;Chen Hainan;Guo Fangzhou;Mu Junbo(Department of Neurosurgery,Guangxi Medical University Cancer Hospital,Nanning 530021,Guangxi Zhuang Autonomous Region,China)

机构地区：[1]广西医科大学附属肿瘤医院神经外科,南宁530021

出　　处：《中国临床解剖学杂志》2022年第3期255-258,共4页Chinese Journal of Clinical Anatomy

基　　金：广西科技基地和人才专项(桂科AD18281055);广西医疗卫生适宜技术开发与推广应用项目(S2019047)。

摘　　要：目的探索内镜经眉弓上锁孔入路暴露颅底中线区域的解剖结构,为临床该术式切除颅底中线区域肿瘤提供解剖学基础。方法内镜经眉弓上锁孔入路解剖5具成人尸头标本,观察该入路暴露的颅底中线区域脑组织、血管及神经。结果内镜经眉弓上锁孔入路可充分暴露前床突及其内侧前颅底硬脑膜、嗅沟及嗅神经;蝶鞍区可显露视神经、视交叉、视交叉前间隙、垂体上动脉、眼动脉、颈内动脉及其周围间隙;上斜坡区域可显露鞍背硬脑膜、乳头体、基底动脉末端、小脑上动脉、大脑后动脉、后交通动脉、动眼神经、滑车神经、三叉神经、面神经、前庭蜗神经及脑桥腹侧。结论内镜经眉弓上锁孔入路切除颅底中线区域肿瘤在解剖学上可行,临床上可作为常规显微镜手术及经鼻内镜入路手术的有效补充。Objective To explore the anatomical structures locating at the middle area of skull base exposed by endoscopic supraorbital keyhole approach,so as to provide reference for clinical resection of tumors in the middle area of skull base.Methods The brain tissues,blood vessels and nerves locating at the middle line area of skull base exposed by endoscopic supraorbital keyhole approach were observed in five formalin fixed adult cadaveric heads.Results Through endoscopic supraorbital keyhole approach,the anterior clinoid process and its medial dura of anterior skull base,olfactory groove and olfactory nerve can be clearly exposed in anterior skull base.Optic nerves,optic chiasm,preoptic chiasm space,superior hypophyseal artery,ophthalmic artery,internal carotid artery and its surrounding space can be exposed in sellar region.The dorsum sellar dura,mastoid body,terminal basilar artery,superior cerebellar artery,posterior cerebral artery,posterior communicating artery,oculomotor nerve,trochlear nerve,trigeminal nerve,facial nerve,vestibular cochlear nerve and ventral pons can be exposed in upper clivus region.Conclusions It is feasible to resect tumors in the midline area of skull base using endoscopic supraorbital keyhole approach,and this approach is an effective supplement to conventional microscope approach and nasal endoscopic transnasal approach in the resection of tumors in midline area of skull base.

关 键 词：内镜 解剖 手术 肿瘤 眶上锁孔入路 

分 类 号：R323.1[医药卫生—人体解剖和组织胚胎学]